RN Care/Case Manager I (Telephonic)

Location: Arkansas-Little Rock
Duration: Full Time
Job ID: 1166891 (21939755)
Category: Case Mgmt RN Job
Company: ProEnlist
Contact: Kat Forester
Job Posted: 08/07/20

RN Care/Case Manager I (Telephonic) - 1166891 (21939755)

About the Company: 
A Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on underinsured and uninsured individuals.  Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans).  

The Company operates local health plans and offers a range of health insurance solutions.  It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.


Position Overview: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care

Responsibilities:

  • Develop, assess and adjust, as necessary, the care plan and promote desired outcome
  • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
  • Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
  • Provide patient and provider education
  • Facilitate member access to community based services
  • Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
  • Actively participate in integrated team care management rounds
  • Identify related risk management quality concerns and report these scenarios to the appropriate resources
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • This is not a remote role and candidates will need to report to Little Rock office Mon-Fri



Qualifications:
Education/Experience:

  • Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred.
  • 2+ years of clinical nursing experience in a clinical, acute care, or community setting.
  • Knowledge of healthcare and managed care preferred.


Licenses/Certifications: Current state’s RN license.


Benefits: 
The company offers more than just medical insurance. They pay most of your benefits costs and in some cases – they pay 100 percent. Most of the benefits not covered by the company are paid with pre-tax payroll deductions. 

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Flexible spending accounts (includes health care, dependent care mass transit reimbursement)
  • Short- and long-term disability insurance
  • Basic Life insurance
  • Supplemental AD&D
  • Supplemental life insurance
  • Wellness Program
  • 401(k) retirement with company match
  • Employee stock purchase plan
  • Vacation, Personal and Sick time
  • Paid Company Holidays
  • Employee Assistance Program (EAP)
  • Training and Learning Opportunities
  • Tuition Reimbursement/Educational Assistance
  • Service Awards
  • On-site fitness center or discount at local fitness centers (most locations)
  • Discounts for select local and national products and services, including cell phones, computers and more
  • Other amenities may be available, but vary by location


Qualifications:
Education/Experience:

  • Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred.
  • 2+ years of clinical nursing experience in a clinical, acute care, or community setting.
  • Knowledge of healthcare and managed care preferred.


Licenses/Certifications: Current state’s RN license.