Nurse Case Manager

Nurse Case Manager

  Not Disclosed

  Remote, IL

  5.0 Months

  Not Disclosed

  Not Disclosed

  Pharmaceutical

Job Description

Description :
Position Summary

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.

Duties

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 procedures.

Experience

Minimum 3-5 years clinical practical experience preferred
Minimum 2-3 years Care Management, discharge planning and/or home health care coordination experience preferred
Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills.
Ability to work independently
Effective computer skills including navigating multiple systems and keyboarding
Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications

***Experience in Case Management and Waiver Services is preferred.
***MS Office Suite ( Excel, Powerpoint, Word, Outlook) and as well as some special Proprietary Applications.


Note :

***Hybrid Model: Remote with the future possibility of onsite

Shift time

Monday-Friday 8am-5pm CST
Requires unrestricted driver's license and car
Requires an RN with unrestricted active license
Field visits are currently on hold due to Covid-19 restrictions, but will resume in the near future. The Position will require travel to members' homes up to 50-75%. Must live near areas listed due to travel requirements and will work at home in-between visits. We want someone who is organized, efficient, and can work independently.
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status