Guidehealth, Remote RN Case Manager - Application via WayUp

WayUp - Joliet, IL

Job Title: Guidehealth, Remote RN Case Manager - Application via WayUp

Position: RN Case Manager

Job Type: Full Time

Pay: $75,000.00 to $85,000.00

Shift:

Work Type: Remote

Location

Address:

City: Joliet

State: IL

ZIP Code:

Job 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 which includes outreach, documentation, monitoring for case progression, and case closure.
Meet reporting and documentation standards while engaging in collaborative meetings with department staff and clients.
Assist members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues.
Educate members on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes.
Support operational aspects of the division to meet the organization’s customer requirements and satisfaction.
Maintain confidentiality related to all computer programs, medical records, and data.
Participate in QM/UM Committee Meetings including material preparation, minutes, data collection, analysis, reporting, and follow-up tasks.
Rotate in off-hour/weekend calls if applicable.
Ensure continued professional growth and education that reflects knowledge and understanding of current nursing care practice.
Perform other responsibilities as assigned and per any changes in annual program requirements.

Required Skills

Core Skills

Current IL Registered Nurse License
Minimum of five years of experience in a variety of health care settings
Highly experienced in Case Management and Chronic Condition Management
Knowledge of utilization review, quality improvement, managed care, and/or community health
Previous remote and/or telephonic work experience
Basic knowledge of case management principles, healthcare management, and reimbursement components
Excellent clinical judgment
Strong verbal and written communication skills
Organizational, problem-solving, and time management skills
Ability to work independently and remotely
Software knowledge including MS Word, Excel, Access, PDF, Outlook
Experience navigating multiple EMR’s
High speed/secured home internet connection
Private HIPAA compliant home office

Preferred Skills

Certification in Case Management

Requirements

Experience: Minimum of five years in a variety of health care settings

Education:

License & Certification:

Current IL Registered Nurse License

Schedule:

COVID-19 Requirements: Not Specified

Benefits

Work from Home: Flexibility to spend less time commuting and more time focusing on professional and personal needs.
Comprehensive Medical, Dental, and Vision plans.
401(k) plan with a 3% employer match to 6% contribution.
Life and Disability insurance provided, with voluntary Life options.
Employee Assistance Program (EAP) support.
Paid time off plans for work-life balance.
Paid parental leave.
Resources dedicated to learning and professional growth.

Supplemental Pay

Not specified

Special Notes

Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer.

Facility Details

Name: WayUp

Description: Guidehealth is a fully remote company committed to advancing value-based healthcare.

Specialties:

Not specified

Mission: At Guidehealth, our values come to life in everything we do. We believe our collective strength is rooted in the unique perspectives of each team member.