Remote Nurse Case Manager — Care Coordination Leader

TRIUNE Health Group; Springfield (MO); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Vacation time (20 days)

holidays (8.5 days)

401(k) match

Medical/Dental/Vision

Disability insurance

EAP

Home office equipment

Travel reimbursement

Job summary

TRIUNE Health Group in Springfield, MO is seeking a skilled Nurse Case Manager to coordinate resources for catastrophically or chronically ill or injured individuals, aiming for quality, holistic goals and timely return to work when appropriate.

You will lead case management efforts with clinicians, employers, and referral sources, ensuring compliant, cost-effective care while navigating HIPAA, FMLA, and related regulations.

Qualifications

• Graduate of an accredited nursing program.
• Current RN licensure in the state of operation.
• Fluency in English (speaking, reading, and writing).
• Three or more years of recent clinical experience, preferably in trauma, psychology, emergency, orthopedics, rehabilitation, occupational health, and neurology.
• CCM preferred.

Responsibilities

• Provide medical case management to individuals through coordination with the patient, physicians, other health care providers, the employer, and the referral source.
• Utilize the steps of Case Management to provide assessment, planning, implementation, evaluation, and outcome of an individual’s progress.
• Evaluate individual treatment plans for appropriateness, medical necessity, and cost-effectiveness.
• Facilitate care, such as negotiating and coordinating the delivery of durable medical equipment and home health services, ensuring clear communication.
• Assess rehabilitation facilities for appropriateness of care, facilitate transportation, and coordinate architectural assessments of patients’ homes when required.
• Communicate medical information clearly and compassionately to patients and families.
• Stay current with medical terminology and the federal and state laws related to health care, Workers’ Compensation, ADA, HIPAA, FMLA, STD, LTD, SSDI, and SSA.
• Utilize technology (computer, cell phone, fax, and scanning machine) to prepare organized, timely reports while complying with safety rules and regulations in conjunction with HIPAA.
• Research medical and community resources for individuals with catastrophic or chronic diagnoses, such as but not limited to AIDS, cancer, spinal cord injuries, diabetes, head injuries, back injuries, hand injuries, and burns, ensuring accessibility for individuals.
• Possess a valid driver’s license with the ability to travel 90% of the time.
• Perform other duties as assigned.

Skills

Leadership

Communication

Analytical

Organizational skills

Multitasking

Education

RN licensure in state

Graduate of accredited nursing program

CCM preferred

Tools

Microsoft Office

Job description

TRIUNE Health Group in Springfield, MO is seeking a skilled Nurse Case Manager to coordinate resources for catastrophically or chronically ill or injured individuals, aiming for quality, holistic goals and timely return to work when appropriate.

You will lead case management efforts with clinicians, employers, and referral sources, ensuring compliant, cost-effective care while navigating HIPAA, FMLA, and related regulations.