Remote RN Case Manager

As a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals. This role includes telephonic member and provider outreach, data collection and analyzation, reporting, clinical review, medical and behavioral health assessments, and documentation in compliance with Federal/State regulation, NCAQ standard, and company policies and procedures. This position is part of the Value Based Care Services team. You will be pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program, coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes, and managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure.