Care Manager, Telephonic Nurse 2 - Knoxville, TN (Work at Home)

    • Flexible / Remote

Description

The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications

  • Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action
  • 3-5 years Managed Care or Case Management experience
  • 3-5 years of experience preferably in an acute care hospital, skilled, rehabilitation or home health clinical setting
  • Experience discharge planning and patient education for adult acute care
  • Knowledge of Medicare Guidelines
  • Comprehensive knowledge of MicrosoftWord, Outlook and Excel with the ability to type and enter data accurately
  • Ability to work independently under general instructions and with a team
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  • Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required


Preferred Qualifications
  • Education: BSN or Bachelor's degree in a related field
  • Knowledge of Milliman or Interqual
  • Certified Case Manager (CCM)


Additional Information
  • Hours for this role are: Monday-Friday 8am-5pm EST
  • Work at Home Position: Candidate should live within a reasonable commuting distance to Knoxville TN


Scheduled Weekly Hours

40


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