Care Manager RN (Remote)

Implement effective utilization management strategies, review health care services, and analyze data to improve provider performance and member satisfaction. Respond to customer inquiries and offer interventions and/or alternatives.

Requirements

• Implement care management review processes consistent with established industry and corporate standards.
• Function in accordance with applicable state and federal laws and regulatory compliance.
• Implement all care management reviews according to accepted and established criteria.
• Promote quality and efficiency in the delivery of care management services.
• Respect the member's right to privacy, sharing only information relevant to the member's care and within the framework of applicable laws.
• Practice within the scope of ethical principles.
• Identify and refer members whose healthcare outcomes might be enhanced by Health Coaching/case management interventions.
• Employ collaborative interventions which focus, facilitate, and maximize the member's healthcare outcomes.

Benefits

• Health Insurance
• Paid Time Off
• Retirement Plan
• 401k Matching
• Employee Assistance Program