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Remote Registered Nurse Case Manager

Company: A-Line Staffing Solutions
Location: Richmond
Posted on: January 12, 2021

Job Description:

A Remote Registered Nurse Case Manager is needed for a major insurance company!Position is a full time work at home position. No travel to member's home or offices.Virginia RN License required.Monday - Friday 8a-5pSummary:The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Responsibilities:* Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.* Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits* Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and proceduresJob Requirements:* 3-5 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.* Healthcare and/or managed care industry experience.* Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding* Effective communication skills, both verbal and written.* Ability to multitask, prioritize and effectively adapt to a fast paced changing environment* Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.* Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.* Typical office working environment with productivity and quality expectations

Keywords: A-Line Staffing Solutions, Richmond , Remote Registered Nurse Case Manager, Executive , Richmond, Virginia

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