Clinical Case Manager-Registered Nurse

Alight Solutions; New Jersey; Remoto; USD 95.000 - 125.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health coverage starting Day One

Dental and vision coverages starting 

Wellbeing programs

Retirement plans with contribution {??

Generous time off

Parental leave

Continuing education

Career growth opportunities

Descrizione del lavoro

Alight Solutions is seeking a Clinical Case Manager-RN in New Jersey to provide clinical case management, coordinate disability and absence claims, and support medically sound decisions for client employees.

The role requires RN/NP licensure with 5+ years in medical advisory areas and 2+ years as a Clinical Case Manager. Flexible working options and strong emphasis on patient advocacy are highlighted.

Competenze

• Be a Registered Nurse, Nurse Practitioner, or comparable license with experience, with working knowledge of disability, client processes, and case management.
• Have minimum of 5 years medical advisory experience in occupational health, worker compensation, disability, health case management, or utilization review.
• Have minimum of 2 years' experience as a Clinical Case Manager.
• Demonstrate dedication to providing high quality customer service, using diplomacy, patient advocacy, and professional competency.
• Foster interest in collaborating with compassionate clinicians and leaders who prioritize mutual care and the well-being of customers and employees.
• Have relevant education and valid licensure.

Mansioni

• Serving as primary resource on team managing medical disability and accommodation cases.
• Delivering case presentations to a panel, utilizing communication, critical thinking, negotiation, holistic case analysis, and proactive case management skills.
• Displaying a professional/corporate presence and presentation style with the ability to demonstrate excellent problem-solving skills when questioned on your case management plans.
• Consulting on medical, behavioral health, and accommodation claims as needed, if within the scope of licensure and clinical expertise.
• Supporting employee-clients in making informed decisions through patient advocacy aligned with Medical Disability Guidelines (MDG), employer benefit plans, and disability management regulations.
• Acting as a liaison between all parties required in case management to facilitate continuous communication and consensus.
• Serving as a liaison to the client's EAP, coordinate care, and encourage referrals to top behavioral health providers.
• Providing documentation, feedback, and reports to diverse occupational populations with an underlying emphasis on returning medically able individuals to productive endeavor.
• Managing caseload efficiently, organizing priorities, provides timely interventions, and maintains sensitivity to confidential records. Driving return to work process from beginning of case to closure.
• Ensuring quality standards for case management are met; implement Alight’s continuous quality improvement process whenever efficiencies or quality standards are not met.

Conoscenze

Clinical case management

Disability claims handling

MDGuidelines knowledge

Formazione

Nursing licensure (RN/NP)

Descrizione del lavoro

Consulting Regular Virtual, New Jersey, United States of America

Come make a difference and consider this unique opportunity to step into a rewarding career.

Amazing Opportunity and Great Place to Work!

Our Story

At Alight, we believe a company’s success starts with its people. Alight embraces values that come directly from our people - purposeful, human, united and growth-minded - reflecting our inclusive culture and promise that our clients expect. We are passionate about connecting purpose with impact. Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management.

Our Benefits

• Health coverage starting Day One


• Dental and vision coverages starting Day One


• Wellbeing programs


• Retirement plans with contribution matching


• Generous time off


• Parental leave


• Continuing education


• Career growth opportunities

Flexible Working

So that you can be your best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and “Top 100 Company for Remote Jobs” 6 years in a row.

Great Place to Work

Thanks to the work of every colleague, Alight has received multiple awards of recognition including “Great Place to Work” for the past 7 years and Fortune’s “Best Companies to Work For.”

About the Role

The Clinical Case Manager-RN will offer clinical expertise, act as a liaison in disability cases, and utilize MDGuidelines to support medically sound decisions. They will ensure effective administration of absence and disability claims while delivering compassionate care to client employees.

Responsibilities

• Serving as primary resource on team managing medical disability and accommodation cases.


• Delivering case presentations to a panel, utilizing compelling communication, critical thinking, negotiation, holistic case analysis, and proactive case management skills.


• Displaying a professional/corporate presence and presentation style with the ability to demonstrate excellent problem-solving skills when questioned on your case management plans.


• Consulting on medical, behavioral health, and accommodation claims as needed, if within the scope of licensure and clinical expertise.


• Supporting employee-clients in making informed decisions through patient advocacy aligned with Medical Disability Guidelines (MDG), employer benefit plans, and disability management regulations.


• Acting as a liaison between all parties required in case management to facilitate continuous communication and consensus.


• Serving as a liaison to the client's EAP, coordinate care, and encourage referrals to top behavioral health providers.


• Providing documentation, feedback, and reports to diverse occupational populations with an underlying emphasis on returning medically able individuals to productive endeavor.


• Managing caseload efficiently, organizing priorities, provides timely interventions, and maintains sensitivity to confidential records. Driving return to work process from beginning of case to closure.


• Ensuring quality standards for case management are met; implement Alight’s continuous quality improvement process whenever efficiencies or quality standards are not met.

Requirements

• Be a Registered Nurse, Nurse Practitioner, or comparable license with experience, with working knowledge of disability, client processes, and case management.


• Have minimum of 5 years medical advisory experience in occupational health, worker compensation, disability, health case management, or utilization review.


• Have minimum of 2 years' experience as a Clinical Case Manager.


• Demonstrate dedication to providing high quality customer service, using diplomacy, patient advocacy, and professional competency.


• Foster interest in collaborating with compassionate clinicians and leaders who prioritize mutual care and the well-being of customers and employees.


• Have relevant education and valid licensure.

Application and Interview

By applying for a position with Alight, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight’s employment policies. Background checks may include some or all the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position.

Alight requires all virtual interviews to be conducted on video. Please be aware that Alight is a camera-on culture and may require occasional travel to one of our physical office locations.

Our commitment to Inclusion

We celebrate differences and believe in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful.

At Alight, we welcome and embrace all individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to thrive. Join us in building a brighter, more inclusive future.

As part of this commitment, Alight will ensure that persons with disabilities are provided reasonable accommodations for the hiring process. If reasonable accommodation is needed, please contact [e-mail] .

Equal Opportunity Policy Statement

Alight is an Equal Employment Opportunity employer and does not discriminate against anyone based on sex, race, color, religion, creed, national origin, ancestry, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state, or local law. In addition, we take affirmative action to employ disabled persons, disabled veterans, and other covered veterans.

Alight provides reasonable accommodations to the known limitations of otherwise qualified employees and applicants for employment with disabilities and sincerely held religious beliefs, practices and observances, unless doing so would result in undue hardship. Applicants for employment may request reasonable accommodations/modifications by contacting their recruiter.

Authorization to work in the Employing Country

Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not, now or in the future, require sponsorship of a visa for employment authorization in the Employing Country and with Alight.

Note, this job description does not restrict management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.

Department of Labor Regulations

Under Department of Labor Regulations (29 CFR Part 471) federal contractors and subcontractors are required to inform employees of their rights under the National Labor Relations Act.

Salary Pay Range

• Minimum : 95,000.00 USD


• Maximum : 125,000.00 USD

Pay Transparency Statement: Alight considers a variety of factors in determining whether to extend an offer of employment and in setting the appropriate compensation level, including, but not limited to, a candidate’s experience, education, certification/credentials, market data, internal equity, and geography. Alight makes these decisions on an individualized, non-discriminatory basis. Bonus and/or incentive eligibility are determined by role and level. Alight also offers a comprehensive benefits package; for specific details on our benefits package, please visit: Wellbeing and Benefits Selector Page - Alight

Please do not use generative AI tools during the application process. We aim to understand your genuine interest in our company without the use of generative AI systems, and we also want to evaluate your non-generative AI assisted communication skills. Any use of generative AI tools in violation of this request may result in disqualification from consideration for the position.

Alight is a leading benefits administration provider of health, wealth, leave and point solutions for many of the world’s largest organizations and over 30 million people. Through the administration of employee benefits, Alight helps clients gain a benefits advantage while building a healthy and financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, absence management and navigation. Our Alight Worklife® platform empowers employers to gain a deeper understanding of their workforce and engage them throughout life’s most important moments with personalized benefits management and data-driven insights, leading to increased employee wellbeing, engagement and productivity. Learn more at alight.com.