Remote RN Case Manager – Indiana

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