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Remote Case Manager II (RN)

Location : San Antonio, TX (Remote)
Job Type : Contract
Reference Code : 15244
Hours : Full Time
Required Years of Experience : 2-4
Required Education : Bachelor’s Degree in Nursing from an accredited nursing program
Travel : No
Relocation : No
Job Industry : Healthcare - Health Services
Job Category : Healthcare - Support Services

Job Description :

We have an immediate opening for a Remote Case Manager with an active, unrestricted Texas State RN license to join our team in San Antonio or Bexar, TX! **PLEASE NOTE: Candidate must have 2+ years of hospital-based clinical RN experience, 2-4 years current or recent case management experience, dependable transportation and auto insurance to complete face-to-face visits (once resumed) to be considered - no exceptions! STAR+PLUS and/or home health experience preferred.

Shift: Full-time 40 hrs/wk


Salary: up to $43/hr


Job Responsibilities: 

Identifies members with chronic or complex conditions that may qualify for potential case management services. Proactively provides case management services to qualified members by developing and implementing a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs. Performs ongoing monitoring, documentation and any necessary modifications of the plan of care to evaluate effectiveness and reach optimal outcomes by conducting face-to-face or home visits as required. Promotes integration of services for members including behavioral health and long term care to enhance the continuity of care for members. Assists orientation and mentoring of new team members as appropriate.

Required Qualifications :

Job Requirements: 

Knowledge of applicable state, and federal regulations, ICD-9, CPT coding, HCPC and SSI. Knowledgeable about Coordination of benefits, and Third Party Liability programs and integration. Familiarity with NCQA standards, state/federal regulations and measurement techniques. In-depth knowledge of CCA and/or other Case Management tools. Manages and completes assigned work plan objectives and projects in a timely manner. Attends regular staff meetings and participates in Interdisciplinary Care Team (ICT) meetings. Maintains professional relationships with provider community and internal and external customers. Participates in appropriate case management conferences to continue to enhance skills/abilities and promote professional growth.

Required Education:

  • Bachelor’s Degree in Nursing from an accredited nursing program

Required Experience:

  • 2+ years of hospital-based clinical RN experience AND 2-4 years current or recent case management experience

  • Computer skills and experience with Microsoft Office Products

  • Excellent verbal and written communication skills

Required Licenses/Certifications:

  • Active, unrestricted TX State RN license

  • Valid driver’s license

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