Remote RN Case Manager - Behavioral Health
Guide-Health
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Job summary
Guidehealth is seeking a Remote RN Case Manager licensed in Illinois to support member management, enhance satisfaction, and navigate the health care system as part of Value Based Care Services. The role focuses on data collection, clinical review, and collaboration with providers to improve outcomes while maintaining HIPAA compliance.
You will conduct telephonic outreach, manage cases, and ensure timely, cost-effective interventions.
Qualifications
- Current IL Registered Nurse license is required.
- Minimum five years of experience in various healthcare settings.
- Proven experience in case management and chronic condition management.
- Remote/telephonic work experience is preferred.
- Experience with EMR systems and utilization review is a plus.
Responsibilities
- Pull data to determine member eligibility for health programs.
- Coordinate care that is timely, effective, equitable, safe, and member-centric.
- Manage case assignments, outreach, documentation, progression and closure.
- Meet reporting standards and collaborate with staff and clients.
- Educate members on navigating the HMO and healthcare system.
- Maintain confidentiality of medical records and data.
- Participate in QM/UM committee activities and prepare materials.
- Remote work with independent multi-tasking as needed.
Skills
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Job description
Guidehealth is seeking a Remote RN Case Manager licensed in Illinois to support member management, enhance satisfaction, and navigate the health care system as part of Value Based Care Services. The role focuses on data collection, clinical review, and collaboration with providers to improve outcomes while maintaining HIPAA compliance.
You will conduct telephonic outreach, manage cases, and ensure timely, cost-effective interventions.
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