Rn Care Manager Remote Jobs in Arkansas

Minimum two (2) years of recent experience in direct care of elders or adults with disabilities

Proficiency in common software and web-based applications (e.g. MS Office, case management systems)

Trains, evaluates and supports Caregivers in conjunction with the care manager as needed on an on-going basis

Submits semi-annual health-status reports to each member’s PCP based on regulatory requirements

Additional state-specific qualifications may be required.

Completes and coordinates all applicable clinical assessments and clinical evaluations

Performs member or provider-related administrative support, including benefit verification, authorization management, and case documentation.

Screens and prioritizes members using targeted intervention business rules and processes to identify necessary services.

Transitions members to appropriate clinical resources/programs as necessary.

Provides general support and coordination services for the department, including answering telephone calls, taking messages, and assisting in problem-solving.

Assists with reporting, data tracking, gathering, organization, and dissemination of information.

Pay Range: $20/hr - $24/hr

Performs member or provider related administrative support which may include benefit verification, authorization management and case documentation.

Must have a Laptop/computer with internet to work from home.

This position is 100% remote. The office is located in Baltimore, MD.

Excellent customer service skills to interact effectively with patients, families, healthcare professionals, and other team members.

Must be fully vaccinated (If not vaccinated, need an exemption letter)

Comfortable providing a Photo ID Copy

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Identifies appropriate benefits and eligibility for requested treatments and/or procedures.

Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.

Analyzes clinical service requests from members or providers against evidence based clinical guidelines.

Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and its members.

Processes requests within required timelines.

Investigates opportunities for health care alternatives and prepares cost effective plans to offer patients, families, and providers.

Refers appropriate cases to Case Manager RNs for assessment.

Must have 3 years recent hospital, home health, or acute care experience.

Strong analytical, problem solving, memory retention, organizational and detail-oriented skills.

Excellent communication skills with the ability to interact with all levels of staff, members and providers as needed.

Medical, Dental, Vision, Pharmacy, Life, & Disability

·Actively participate in integrated team care management rounds

·Identify related risk management quality concerns and report these scenarios to the appropriate resources

·Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems

·Outreach and enroll members into the Care Management Program

Location:Remote : All over US

·Provide patient and provider education

Perform case conferences, summary reports, and incident management in compliance with applicable state and program regulatory and/or accreditation requirements

Solid understanding and experience in care planning/case management is required

Manage a caseload and leverage technology to enable effective coaching and information referral

4-6 years’ experience in health coaching and/or experience in health care/wellness

Comprehensive knowledge of industry concepts and principles; Ability to provide coaching support and consultation across a broad range of clinical topics

Exceptional active listening and communication skills with a focus on empathy