Full-time, RN Case Manager
- Competitive Compensation & Benefits
- Collaborative & Supportive Company Culture
- Primarily Telecommuting Position
- Portland-Clackamas, OR – Business Location
*Qualified candidates must permanently reside either in Oregon, Washington, Nevada, or Arizona
Are you seeking a rewarding career opportunity where your professional talents will be recognized, utilized, and appreciated? If so, we encourage you to apply to our opening!
Innovative Care Management (ICM) is seeking an experienced RN Case Manager to join our growing and dynamic team and to provide telephonic case management in a primarily telecommuting organization. The right candidates will possess strong clinical, nursing, and critical thinking skills, as well as case management knowledge and expertise. The ability to work remotely and to openly communicate with all levels of the organization are key requirements. A successful candidate will possess strong computer skills and general comfort navigating various digital platforms to ensure success during remote training with limited in person interactions with team members. Compact RN license must be active. ICM has been providing telecommuting nursing opportunities for over 25 years and is committed to maintaining a strong telecommuting model even when the current public health crisis is resolved.
Who We Are – What We Embrace:
Innovative Care Management is an equal opportunity employer. As an organization, we fully embrace diversity and inclusion. We believe and uphold that equity, diversity, and inclusion are woven into every level of our business. As a team, we continue to build a company culture that respects, empowers, and encourages our employees, while at the same time elevating the diverse and unique contributions they make. We embrace and celebrate these contributions as they inspire innovation and our ability to connect, empathize, and care for our patients as well as the diverse communities we support and serve.
Under the general direction of the Manager, Care Management Programs, the Case Management Nurse has responsibility for providing Case Management services to patients identified for or enrolled in case management. The Case Management Society of America (CMSA) defines case management as “a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote patient safety, quality of care, and cost effective outcomes.”
Specific Position Requirements and Responsibilities:
- Review program referrals for appropriateness of program enrollment, considering the patient, medical condition, and individual ICM customer parameters.
- Provide care coordination services to patients in the case management program, including educating, motivating, and empowering members to manage their medical condition(s).
- Telephonically manage medical conditions of our client populations, facilitating care between the patient and physician, education for self-management, and positive outcomes for the member.
- Work towards member wellness and autonomy through advocacy, communication, education, identification of service resources, and service facilitation, performing the following activities on an ongoing basis relative to each enrolled patient:
- Identify and coordinate appropriate providers, services, facilities, and community resources throughout the continuum of services, helping to ensure available resources are being used in a timely and cost-effective manner to obtain optimum value for patients and payors.
- Conduct and complete utilization management and concurrent review processes on assigned patients, extending authorization or length of stay as appropriate.
- Provide support and maintain cooperative working relationships with all Innovative Care Management departments.
- As part of the Care Management Nurse triage program, provides clinical advice and case management support to ICM departments.
- Maintain accurate records of all communications and interventions related to patient related activities using appropriate ICM software.
- Provide timely verbal and written reports (to include interventions and estimated cost savings) to associated clients as directed.
General Employee Requirements and Responsibilities:
- Establish effective rapport with all employees, company management, customers, clients, TPA partners, members, and physicians; actively maintaining ICM’s philosophy of non-adversarial patient advocacy.
- Actively support company and departmental QA/QI initiatives.
- Actively support departmental and corporate strategic plans and ensure successful implementation.
- Comply with all HIPAA compliance rules including Privacy, Security and Breach Notification.
- Follow all guidelines listed under the Code of Conduct in the Employee Handbook.
- Understand and comply with the Innovative Care Management Compliance program as outlined in the Employee Handbook.
- Demonstrate a clear understanding of the Mission, Purpose and Philosophy.
- Maintain confidentiality of all company and patient related information. Protect patient rights as defined in the patient Bill of Rights.
- Adhere to ethical business practices by striving to perform in a manner that conforms to the highest standards of ethical behavior, integrity, and honesty.
- Promote a safe and efficient working environment by adhering to agency policies and procedures.
- Treat employees, patients, and business partners with respect. Foster teamwork by trusting and supporting each other while encouraging collaboration at all levels of the organization.
- Honor diversity and supports cultural awareness through daily work and customer interaction.
- Promote health literacy by communicating in ways that are understandable to ICM clients. Be conscious of the use of plain language while avoiding the use of complex medical terms or jargon when interfacing directly with or writing content for consumers.
Work Experience, Qualifications, Additional Skill and Abilities, and Professional Competencies:
- 5 years of clinical knowledge and experience, required.
- Ability to effectively communicate, both in verbal and written form.
- Ability to use a computer and quickly learn and master different software platforms as needed to perform assigned tasks and responsibilities.
- Self-motivated with the ability to telework, take initiative and work effectively in both an independent and collaborative business environment.
- Excellent relationship management skills, including a high degree of psychological sophistication and non-aggressive assertiveness.
- Demonstrated ability to problem solve multifaceted and/or emotionally charged situations.
- Ability to engage in abstract thought.
- Ability to successfully manage conflict, negotiating “win-win” solutions.
- Strong organizational, task prioritization, and delegation skills.
- Previous training and demonstrated competence in medical necessity determinations, quality assurance and patient outcomes.
- Previous experience in evidenced based criteria.
- Strong focus on patient advocacy and empathy.
Education, Licensure, and Certification Requirements:
- Nursing Degree (LPN or RN) from Accredited School of Nursing, required.
- Bachelor’s degree (or higher) in health-related field, preferred.
- Proof of successful completion of educational requirements for a Registered Nurse (RN) as defined by the state in which the employee is to practice as well as proof of such licensure in good standing, required.
- Must obtain sufficient continuing education to maintain active licensure in each state where continuing education units (CEUs) are required.
- Ability to obtain other state licenses as required.
Work and Physical Conditions:
- Ability to use a computer keyboard and mouse 6-8 hours per day.
- Ability to dial, answer, and talk on a telephone with a headset for 6-8 hours per day.
- Ability to engage in sedentary activity by sitting or standing at a workstation for 6-8 hours.
- Ability to lift and transport office and computer equipment between office and home; less than 20 pounds.
Please send us a copy of your resume and cover letter to: firstname.lastname@example.org. In your cover letter, please let us know why you feel your credentials are a good match for this position within our organization.
You can also learn more about a career at ICM at: http://www.innovativecare.com/about-us/careers/.
For additional information regarding Innovative Care Management, please visit our website at: www.innovativecare.com.
Related keywords: registered nurse, rn, utilization review nurse, nurse, utilization review, remote nurse, rn work from home’
- Waiting period may apply.
- Remote interview process
- Social distancing guidelines in place
- Virtual meetings
- Work is exclusively remote
Relocation Assistance Provided:
This Job Is:
- A job for which military experienced candidates are encouraged to apply
- From $42.00 per hour
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible schedule
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Tuition reimbursement
- Vision insurance
- Day Shift
- Monday to Friday
- Only permanent residents of Arizona, Oregon, Washington or Nevada will
- be considered. Please respond with your permanent state of residence.
- Associate (Required)
- Case management: 1 year (Required)
- Clinical: 5 years (Required)
- Compact RN License (Required)
Innovative Care Management, Inc.
PO BOX 22386
Portland, OR 97269