Offer summary

Qualifications:

Registered Nurse (RN) with an unrestricted active license in North Carolina., 2-3 years of clinical practice experience in a hospital or alternative care setting., 2 years of experience in the healthcare and/or managed care industry., Proficiency in computer skills and effective communication abilities..

Key responsibilities:

Conduct comprehensive assessments of referred members' needs and eligibility.

Utilize clinical tools to determine case resolution and evaluate benefit plans.

Ensure compliance with regulatory and accreditation guidelines in case management processes.

Adapt to a fast-paced environment while managing multiple tasks effectively.

Job description

Our Client, a Retail Pharmacy company, is looking for a Nurse Case Manager II for their Remote location.

Responsibilities:

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 North Carolina.
Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and 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 while assessing benefits and/or member's needs to ensure appropriate administration of benefits. Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
Effective communication skills, both verbal and written.
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
Typical office working environment with productivity and quality expectations.

Requirements:

Verifyable High School Diploma or GED Required
License Registered Nurse required
Case Management experience required
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.

Why Should You Apply?

Health Benefits
Referral Program
Excellent growth and advancement opportunities

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.

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