RN Case Manager

CONFLUX SYSTEMS; Pennsylvania; Remote; USD 80,000 - 90,000; Full time

Job summary

A leading company is seeking a Nurse Case Manager II for a 6-month contract role. This remote position requires an active RN license and involves assessing and coordinating care for members, focusing on improving health outcomes. Candidates should have significant clinical experience and strong communication skills.

Qualifications

• Minimum 3-5 years of clinical practical experience.
• Minimum 2-3 years of CM, discharge planning, and/or home health care coordination experience.
• Bilingual skills desired.

Responsibilities

• Responsible for assessing, planning, implementing, and coordinating all case management activities.
• Develops a proactive plan of care to enhance outcomes.
• Collaborates with supervisors and key stakeholders.

Skills

Analytical skills

Problem-solving skills

Effective communication

Organizational skills

Interpersonal skills

Education

Active state license as a Registered Nurse

Certified Case Manager certification (preferred)

Tools

MS Word

Excel

Outlook

PowerPoint

Job description

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Here are the job details for your review:

Job Title: Nurse Case Manager II

Duration: 6 Months Contract (Potential for extension)

Location: Remote

Pay Rate: $40.00/HR on W2

Shift Hours: Mon to Fri 8am to 5pm EST

Must be licensed in the state of NY*

RN with current unrestricted state licensure. REQUIRED

**PUT ON RESUME*** · Registered Nurse with active state license in good standing within the region where the job duties are performed is required.

**Please list candidate's state at the top of resume - candidates can reside anywhere but EST residents are preferred and must work EST hours**

Program Overview

Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have a life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ healthcare and social determinant needs. Join us in this exciting opportunity as we grow and expand DSNP to change lives in new markets across the country.

Position Summary/Mission

Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate their medical needs and facilitate overall wellness.

Requires an RN with unrestricted active license

· Develops a proactive plan of care to address identified issues to enhance short and long-term outcomes as well as opportunities to improve overall wellness.

· Uses clinical tools and information/data review to evaluate members' needs and benefits.

· Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators impacting care planning.

· Conducts assessments considering information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.

· Uses a holistic approach to assess the need for referrals to clinical resources and other interdisciplinary team members.

· Collaborates with supervisors and other key stakeholders in the member’s healthcare, overcoming barriers to meeting goals, and presents cases at interdisciplinary case conferences.

Utilizes case management processes in compliance with regulatory and company policies and procedures. Uses motivational interviewing skills to ensure maximum member engagement and discern their health status and needs based on key questions and conversations.

Experience

· Minimum 3-5 years of clinical practical experience

· Minimum 2-3 years of CM, discharge planning, and/or home health care coordination experience

· Confidence working remotely/independent thinker, using tools to collaborate and connect virtually

· Bilingual skills desired

· Excellent analytical and problem-solving skills

· Effective communication, organizational, and interpersonal skills

· Ability to work independently

· Proficiency with standard corporate software applications, including MS Word, Excel, Outlook, PowerPoint, and some proprietary applications

Education

· Active state license as a Registered Nurse is required

· License in the state of residence preferred, especially if in a compact licensure state

· Certified Case Manager certification is preferred

Seniority level

• Mid-Senior level

Employment type

• Contract

Job function

• Health Care Provider, Other, Customer Service

Industries

• Hospitals and Health Care, Public Health, Health and Human Services