Remote RN Case Manager – Indiana

Job Overview

  • Clinical License RN
  • State(s) IN

Full job description

Position: Case Manager

Client: Health Insurance Client

Location: Remote (Indiana)

Duration: 6-month Contract-to-Hire

Start: ASAP

Overview:

The RN Case Manager plans and coordinates care for patients from pre-admission through post-discharge by working collaboratively with the multidisciplinary team. Ensures that patients are assigned the appropriate level of care, receive the appropriate services and are transitioned to the appropriate post-discharge level of care. Performs accurate, timely and effective discharge planning for patients. Works with third party payers to ensure coverage. Administers education and prevention programs.

Qualifications:

  • Associate’s Degree in Nursing or Bachelor’s Degree in Social Work required.
  • Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license OR a Social Work license in the state of Indiana.
  • Certification in Case Management preferred.
  • Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
  • Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
  • Ability to comprehend third party contractual arrangements is preferred.
  • Understanding of the third party denial and appeal process is preferred.
  • Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.
  • 3-5 years of experience preferred.

Job Type: Full-time

Benefits:

  • Dental insurance
  • Health insurance
  • Vision insurance

Schedule:

  • 8 hour shift
  • Monday to Friday

Work setting:

  • Remote

Application Question(s):

  • Do you have a valid Indiana RN license or Compact State RN License?
  • Do you have a valid Social Work license in the state of Indiana? Please state which license you currently hold.
  • How many years of Health Insurance Industry/Managed Care experience do you have?

Experience:

  • Case management: 3 years (Preferred)
  • InterQual: 1 year (Preferred)
  • Milliman (MCG): 1 year (Preferred)
  • Cerner: 1 year (Preferred)

Location:

  • Indiana (Required)

Work Location: Remote

 

 

 

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