RN Case Manager - Behavioral Health
New
G
GuidehealthHealthcare case management
Source API remote eligibility restrictions: United StatesFull-TimeManager
Salary90,000 USD per year
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Job Details
- Experience
- Minimum of five years of experience in a variety of health care settings.
- Required Skills
- Microsoft Excel
Requirements
- Hold a current Illinois Registered Nurse license.
- Complete 20 hours of continuing education per two-year license renewal cycle, as required by Illinois.
- Have at least five years of experience in a variety of healthcare settings.
- Have strong experience in case management and chronic condition management.
- Know utilization review, quality improvement, managed care, and/or community health.
- Have previous remote and/or telephonic work experience.
- Know case management principles, healthcare management, and reimbursement components; have experience with motivational interviewing.
- Demonstrate clinical judgment, verbal and written communication, organization, problem-solving, and time-management skills.
- Be able to work independently and remotely, multitask, prioritize, and respond to changing business needs.
- Know word-processing and spreadsheet software, including MS Word, Excel, Access, PDF, and Outlook.
- Have experience navigating multiple EMRs.
- Maintain high-speed, secured home internet, a private HIPAA-compliant home office with a locking door, and backup internet connection options.
- Case Management certification is preferred but not required.
Responsibilities
- Pull, sort, and analyze data to determine member eligibility for the Population Health management Program.
- Coordinate and provide timely, effective, equitable, safe, and member-centric care while following HMO processes.
- Manage case assignments, including outreach, documentation, monitoring case progression, and case closure.
- Meet reporting and documentation standards and participate in collaborative meetings with department staff and clients.
- Help members address barriers, social determinants, motivators, and psychosocial issues to reach wellness and health autonomy.
- Educate members on navigating the HMO and healthcare system and promote quality, cost-effective interventions and outcomes.
- Participate in QM/UM committee meetings, including preparing materials, taking minutes, collecting and analyzing data, reporting, and follow-up.
- Maintain confidentiality of computer programs, medical records, and data.
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