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