Skip to main content
Iconma Portal logo

Nurse Case Manager II

Iconma Portal
4 days ago
Remote
$15 - $33.30 USD hourly
Case Management
Our Client, a Retail Pharmacy company, is looking for a Nurse Case Manager II – Florida for their Remote location.
 
Responsibilities:
  • 50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care.
  • Compiles all available clinical information and partners with the member to develop an individualized care plan that encompasses goals and interventions to meet the member’s identified needs.
  • Provides evidence-based disease management education and support to help the member achieve health goals.
  • Ensure the appropriate members of the interdisciplinary care team are involved in the member’s care.
  • Provides care coordination to support a seamless health care experience for the member.
  • Meticulous documentation of care management activity in the member’s electronic health record.
  • Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition.
  • Identifies and connects members with health plan benefits and community resources.
  • Meets regulatory requirements within specified timelines.
  • The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed.
  • Additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring new team members.
  • Essential Competencies and Functions:
  • Ability to meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements of this role.
  • Conduct oneself with integrity, professionalism, and self-direction.
  • Experience or a willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care.
  • Familiarity with community resources and services.
  • Ability to navigate and utilize various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records.
  • Maintain strong collaborative and professional relationships with members and colleagues.
  • Communicate effectively, both verbally and in writing.
  • Excellent customer service and engagement skills.
  • Work Expectations
  • Access to a private, dedicated space to conduct work effectively to meet the requirements of the position
  • Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.
 
Requirements:
  • Candidate must have active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence
  • Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools within the context of the Care Manager – Registered Nurse (CM RN) role
  • Access to a private, dedicated space to conduct work effectively to meet the requirements of the position
  • Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.
  • Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually
  • 3+ years of nursing experience
  • 2+ years of case management, discharge planning and/or home healthcare coordination experience
  • Preferred Qualifications:
  • Experience providing care management for Medicare and/or Medicaid members
  • Experience working with individuals with needs, chronic medical conditions, and/or behavioral health
  • Experience conducting health-related assessments and facilitating the care planning process
  • Bilingual skills, especially English-Spanish
  • Education:
  • Add the minimum level of required completed education and certifications required
  • Associate’s of Science in Nursing (ASN) degree and relevant experience in a health care-related field (required)
  • Bachelor’s of Science in Nursing (BSN) (preferred)
  • Verifyable High School Diploma or GED Required: Yes
 
Why Should You Apply?