Remote RN Case Manager – Population Health

SmartRecruiters, Inc.; Kenosha (WI); Remote; USD 85,000 - 100,000; Full time

Benefits offered by this job

Work from Home

Medical, Dental, Vision benefits

401(k) with company match

Life and Disability insurance

Employee Assistance Program (EAP)

Paid time off

Paid parental leave

Professional growth resources

Job summary

Guidehealth is seeking a fully remote Registered Nurse Case Manager licensed in Illinois to enhance member management, optimize satisfaction and cost effectiveness, and navigate the health care system as a collaborative partner.

You will perform telephonic outreach, data collection, clinical review, and documentation in compliance with federal/state regulations and company policies. This role is part of the Value Based Care Services team.

Qualifications

• Current IL Registered Nurse License; 20 hours of CE per 2-year renewal cycle.
• Minimum of five years of experience in healthcare settings.
• Experience in Case Management and Chronic Condition Management.
• Knowledge of utilization review, quality improvement, managed care, or community health.
• Remote/telephonic work experience.

Responsibilities

• Pull, sort, and analyze data to determine member eligibility for Population Health management.
• Coordinate care that is timely, effective, equitable, safe, and member-centric per HMO processes.
• Manage case assignments: outreach, documentation, monitoring, case closure.
• Meet reporting and documentation standards; participate in collaborative meetings with staff and clients.
• Assist members in wellness and autonomy by addressing barriers and psychosocial issues.

Skills

Verbal communication

Written communication

Clinical judgment

Organization

Problem solving

Time management

Independence

Remote work capability

Education

IL Registered Nurse License

Tools

MS Word

Excel

Access

PDF

Outlook

EMR navigation

Job description

Guidehealth is seeking a fully remote Registered Nurse Case Manager licensed in Illinois to enhance member management, optimize satisfaction and cost effectiveness, and navigate the health care system as a collaborative partner.

You will perform telephonic outreach, data collection, clinical review, and documentation in compliance with federal/state regulations and company policies. This role is part of the Value Based Care Services team.