[Remote] Remote RN Case Manager (Payer/Insurance Experience Required)

Note: The job is a remote job and is open to candidates in USA. Insight Global is seeking a passionate and highly motivated Nurse Care Manager to join their dynamic Care and Case Management team. In this telephonic role, you will guide members through their healthcare journey, focusing on proactive engagement with high-risk and rising-risk members, particularly around discharge planning and care transitions. Responsibilities • Engage in high-value Care Management outreach calls for Included Health members with the primary goal of clinically engaging high-risk and rising-risk members, fostering strong relationships and promoting proactive health management. • Make proactive calls to members once their hospital discharge is confirmed, conducting thorough intake assessments if the member is reached. • Collaborate with hospital-based case managers to understand & support members' specific discharge needs and actively encourage members to engage with our Care Management program. • Perform initial assessments encompassing activities of daily living, cognitive functions, social determinants of health (SDOH), health beliefs and behaviors, and life planning activities to develop truly holistic care strategies. • Deliver coordinated, patient-centered virtual Care Management by telephone and/or video that consistently improves members’ health outcomes. • Generate impactful care plans collaboratively with members and our multidisciplinary care team, empowering members to achieve their desired health goals. • Coordinate necessary resources that holistically address members’ problems, whether clinical or social. Skills • Bachelor of Science in Nursing (BSN) • Compact Nursing License with additional Active California Registered Nurse (RN) and Illinois License in good standing. • 5+ years of experience in clinical nursing • 2+ years of experience working in care management, case management, and/or disease management, preferably within a health plan, health navigator, or third-party administrator (TPA) environment. • Remote care or case management experience • Comfortable discussing a wide variety of medical conditions and experienced working with populations across all age ranges. • Strong comfort with technology and high competence in using multiple computer/medical record systems. Benefits • Medical, dental, and vision insurance • HSA • FSA • DCFSA account options • 401k retirement account access with employer matching • Paid sick leave • Other paid time off as provided by applicable law Company Overview • Insight Global provides top talent and staffing solutions that help job seekers find careers in healthcare, finance, IT, and government. It was founded in 2001, and is headquartered in Atlanta, Georgia, USA, with a workforce of 1001-5000 employees. Its website is https://insightglobal.com/. Apply tot his job Apply To this Job