*Nurse Case Manager II

Lancesoft; Oklahoma; Hybrid; USD 61,000 - 63,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401k Contributions

Critical Illness Insurance

Life Insurance

Accident Insurance

Job summary

LanceSoft seeks an experienced RN Case Manager for a remote, fulltime role. The candidate will assess member needs, determine care plans, and advocate for access to benefits and services to meet health goals.

Ideal applicants have 3+ years of clinical practice, healthcare/managed care exposure, and strong communication. CCM certification is preferred, with the position offering comprehensive benefits and W2 employment.

Qualifications

• 3 years clinical practice experience in hospital or similar setting.
• Healthcare/managed care industry experience.
• Proficiency with computer systems and data entry; strong written and verbal communication.

Responsibilities

• Conduct comprehensive assessments of referred members and determine approach to case resolution.
• Assess benefits and eligibility using applicable criteria and guidelines.
• Ensure compliance with regulatory standards and company policies in case management.

Skills

Clinical practice

Communication

Multitasking

Education

RN with current OK license

CCM certification preferred

Job description

Job ID: 26-139891

Position Type: Offsite

Location: Remote

Work Type: Fulltime

Est. Pay Range: $44.14/hr. To $46.00/hr.

All-inclusive on W2

Position Summary

The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

Duties

Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member’s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits. Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Experience

3 years Clinical practice experience, e.G., hospital setting, alternative care setting such as home health or ambulatory care required. Healthcare and/or managed care industry experience. Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Effective communication skills, both verbal and written. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Typical office working environment with productivity and quality expectations.

Education

RN with current unrestricted state licensure state of OK Case Management Certification CCM preferred.

Employee Benefits

At LanceSoft, full time regular employees who work a minimum of 30 hours a week or more are entitled to the following benefits:

• Four options of medical Insurance
• Dental and Vision Insurance
• 401k Contributions
• Critical Illness Insurance
• Voluntary Permanent Life Insurance
• Accident Insurance
• Other Employee Perks

Equal Opportunity Statement

LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time.