Remote RN III: Care-Plan & Care Coordination Lead

NurseRemotely; United States; Remote; USD 80,000 - 100,000; Full time

Benefits offered by this job

Health Benefits

Referral Program

Growth Opportunities

Job summary

NurseRemotely is seeking a licensed RN for a remote case management role with a Health Insurance client. You will design care plans, assess needs and coordinate services across various teams to ensure quality, cost-effective care.

Responsibilities include developing ICPs, reviewing referrals, and promoting adherence to clinical guidelines. Requires DSNP managed care knowledge and strong documentation skills.

Qualifications

• RN license required and active.
• DSNP managed care knowledge preferred.
• Proficient with Microsoft applications and documentation.
• Excellent organization and documentation skills.
• Experience with care plans and care coordination is a plus.

Responsibilities

• Research and design treatment/care plans to promote quality and cost-effective care.
• Initiate ICP based on HRA, participate in interdisciplinary meetings, and support transitions of care.
• Determine referral appropriateness for CM, mental health, and social services.
• Provide referrals to QM, DM, and AGD.
• Conduct member care reviews for continuity of care.
• Manage member treatment to meet LOS and DC planning at appropriate levels.
• Assess health behaviors and barriers, aligning with guidelines.
• Promote improvement in assessment methods and positive outcomes.
• Set realistic goals, involve clients, and adapt plans as needed.
• Develop fiscally responsible plans with targeted interventions.
• Reassess and modify plans as care evolves.
• Identify contingency plans throughout the care process.
• Execute plan based on accurate assessment.

Skills

Agile Experience

Managed Care (DSNP)

Microsoft Applications

Organization & Documentation

Education

RN

Job description

NurseRemotely is seeking a licensed RN for a remote case management role with a Health Insurance client. You will design care plans, assess needs and coordinate services across various teams to ensure quality, cost-effective care.

Responsibilities include developing ICPs, reviewing referrals, and promoting adherence to clinical guidelines. Requires DSNP managed care knowledge and strong documentation skills.