[Hiring] Nurse Case Manager II @Vir Healthway

Role Description

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. Requires an RN with unrestricted active license in Georgia.

• Conducts comprehensive assessments of referred member's needs/eligibility.
• 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.
• Ensures appropriate administration of benefits.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Qualifications

• Must have experience working a remote position previously.
• Must have case management experience.
• 2-3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
• 2 years Healthcare and/or managed care industry experience.
• Case Management experience required.

Requirements

• RN with current unrestricted compact state licensure.
• Case Management Certification CCM preferred.

Benefits

• Duration: 6 Months Contract (Potential for extension)
• Location: Remote - GA
• Pay Rate: $33.87/ HR on W2
• Shift Hours: Monday- Friday 8am - 5pm EST
• Private office space free of any distractions due to HIPPAA Compliance.