Arkansas Blue Cross

Arkansas Blue Cross

RN Case Manager

Arkansas Remote

Sponsorship not specifiedDetected 9 days ago
AccessibilityCRMExcelCustomer SupportPatient CareCommunicationMicrosoft Office

About the role

  • The RN Case Manager plays a critical role in optimizing patient care and resource utilization.
  • The incumbent is responsible for assessing, planning, implementing, coordinating, monitoring, and evaluating comprehensive care plans to meet individual health needs.

Responsibilities

  • Serves as a liaison facilitating a collaborate process which includes patients, families/caregivers, physicians, hospital discharger planners, home care providers and other ancillary providers to promote quality of care, cost effectiveness, accessibility and appropriateness of service levels.
  • Works proactively with referrals from multiple sources to identify appropriate candidates for case management, explains services ensuring voluntary agreement of services and maintains a minimum patient caseload in a timely matter.

Requirements

  • Registered Nurse (RN) with current active state license in good standing in the state(s) where job duties are performed required.
  • Case management certification required.
  • The integrity of information must be maintained as outlined in the company Administrative Manual.

Nice to have

  • Bachelor's degree in Nursing preferred.

Skills

  • Administrative Process
  • Affinite CM
  • Affinite UM
  • CCI Edits
  • Collaborative Communications
  • Critical Reasoning
  • Cross-Functional Planning
  • Customer Relationship Management (CRM)
  • Customer Service Workstation
  • Deductive Reasoning
  • Information Security
  • Interpersonal Relationship Management

Benefits

  • Provides specialized education and knowledge on disease specific conditions as needed and assigned.
  • Remains current with up-to-date medical and surgical procedures, products, healthcare services and drugs, general trends in health care delivery, enterprise procedures, policies and contracts.

This listing is sourced directly from Arkansas Blue Cross's careers page and normalized into a canonical job model.