Case Manager Rn -Remote

Get To Know US!

GuideWell and its family of forward-thinking companies are focused on helping people and communities achieve better health and are at the forefront in the transformation of health care.

As a highly integrated care team we empowers members to optimize their health and achieve their health care goals by providing access to quality and affordable health solutions.

Florida Blue, a GuideWell Company, has been providing health insurance to residents of Florida for 75 years. Driven by its mission of helping people and communities achieve better health, the company serves more than five million health care members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting the member first.

What is your impact?

The Case Manager RN is responsible for assisting members within a geographical (local, statewide and/or other) area make effective health care choices for self-management of their acute and /or chronic condition(s). Utilizing a member-centric approach they assist members, and their families understand and manage their disease process by: reinforcing the physicians' plan of treatment, promoting healthy behaviors and lifestyle changes, and providing education and tools to promote self- management to improve health outcomes and reduce overall costs. Ongoing coaching, monitoring and evaluation of care plans will be done face to face with the member, telephonically, digital engagement or electronically through email and member and provider portals.

What are your key responsibilities?

• Engage Members telephonically, using digital engagement tools and/or face to face at Florida Blue Retail Centers, hospitals, etc. with a focus on health coaching and member education.
• Facilitate access to care and resources to meet the member’s health care needs.
• Provide education and tools to promote self-management.
• Facilitate care for high-risk members across the continuum of the health care experience, including care transitions, coordination of community and social service and coordinating with other value-based organizations, providers as needed.
• Plan, implement, coordinate, and monitor Case Management activities that may include acute and non-acute services, outpatient services, behavioral health and / or community resources.

What is required?

2+ years related work experience. Experience Details: Communicating and building relationships with members/providers/employers both telephonically as well as live

2+ years Acute Care and/or Case Management experience

Related Bachelor’s degree or additional related equivalent work experience

RN - Registered Nurse - State Licensure and/or Compact State Licensure

Experience with influencing and motivating individuals to change health behaviors

Experience with population health

Experience in two or more of the following: home health care, utilization review, discharge planning, disease/ case management

Experience Working With Managed Care Products, Benefits, And Services

Non-traditional working hours to meet the member's availability

Experience in MS Word, Excel, tablet and/or smartphone

Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Occasionally

Must obtain a compact license endorsement within 1 year of hire

Must obtain a Certified Case Manager (CCM) certification within 2 years of hire

What is preferred?

CCM - Certified Case Manager

Bilingual English/Spanish and/or Creole

Direct clinical experience

General Physical Demands

Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

What We Offer:

As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.

To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:

• Leave programs to support personal circumstances;
• Paid time off, volunteer time off, and 11 holidays
• Income protection benefits: life insurance, Short- and long-term disability programs;
• A comprehensive wellness program
• Medical, dental, vision, life and global travel health insurance;
• Retirement Savings Plan includes employer contribution and employer match;
• Additional voluntary benefits available; and

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.

To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.

Annualized Salary Range: $66,400 - $107,900

Typical Annualized Hiring Range: $66,400 - $83,000

Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive, and equitable culture for our employees and communities.