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Case Manager, RN

Req number:

R6346

Employment type:

Full time

Worksite flexibility:

Remote

Who we are

CAI is a global technology services firm with over 8,500 associates worldwide and a yearly revenue of $1 billion+. We have over 40 years of excellence in uniting talent and technology to power the possible for our clients, colleagues, and communities. As a privately held company, we have the freedom and focus to do what is right—whatever it takes. Our tailor-made solutions create lasting results across the public and commercial sectors, and we are trailblazers in bringing neurodiversity to the enterprise.

Job Summary

We are looking for a motivated Case Manager, RN ready to take us to the next level! If you have prior experience with coordinating, implementing, and evaluating effective treatment and are looking for your next career move, apply now.

Job Description

We are looking for a Case Manager, RN to ensure that members with complex medical and/or psychosocial needs have access to high-quality, cost-effective healthcare. You will play a critical role in holistic assessment, planning, coordination, and monitoring care to optimize member health outcomes while advocating for appropriate and efficient care plans. This position will be a remote, full-time, 6-month contract with the opportunity to renew.

Due to the specific legal and contractual requirements associated with this position, only US Citizens will be considered for this role. Candidates must be able to work directly on CAI's W2.

What You’ll Do

+ Conduct holistic assessments to identify members' medical, psychosocial, and resource needs

+ Develop individualized care plans that address unmet needs, set realistic goals, and adjust plans as necessary

+ Facilitate member access to healthcare services through collaboration with internal teams and external providers

+ Educate members about their conditions, care plans, and resources to promote adherence and improve health outcomes

+ Communicate effectively with members, healthcare providers, and internal teams (e.g., Case Management Specialists, Management Teams, Physician Advisors)

+ Coordinate with community organizations, ancillary healthcare providers, and other payers to address member needs

+ Participate in interdisciplinary and/or interagency meetings to ensure efficient care coordination

+ Use clinical judgment and consultation with Physician Advisors to determine appropriate interventions

+ Advocate for members by balancing benefit design, cost-benefit analysis, and care needs to create realistic and impactful care plans

+ Use clinical judgment and consultation with Physician Advisors to determine appropriate interventions

+ Advocate for members by balancing benefit design, cost-benefit analysis, and care needs to create realistic and impactful care plans

+ Attend required meetings, rounds, and in-services to enhance professional knowledge and skills

+ Participate in departmental quality initiatives and work teams

+ Maintain licensure and complete continuing education annually

+ Foster effective team relationships through constructive feedback and conflict resolution

+ Perform other duties as assigned to support the overall success of the team

What You'll Need

Required:

+ Bachelor’s degree in Nursing (BSN) or valid RN certification

+ Minimum of 3 years of experience in Acute Care, Managed Care, or experience working with Medicaid/Medicare populations

+ Strong knowledge of medical terminology, diagnostic categories, and disease states

+ Proven ability to work independently, assess member needs, and develop tailored care plans

Preferred:

+ Case Management Certification (CCM or equivalent)

+ Bilingual proficiency in English and Spanish

Physical Demands

+ Ability to safely and successfully perform the essential job functions consistent with the ADA and other federal, state, and local standards

+ Sedentary work that involves sitting or remaining stationary most of the time with occasional need to move around the office to attend meetings, etc.

+ Ability to conduct repetitive tasks on a computer, utilizing a mouse, keyboard, and monitor

The pay range for this position is $38 - $43 per hour (USD). Exact compensation may vary based on several factors, including location, experience, and education. Benefit packages for this role includes medical, dental, and vision insurance, as well as 401k retirement account access. Employees in this role may also be entitled to paid sick leave as provided by applicable law.

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Reasonable accommodation statement

If you require a reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employment selection process, please direct your inquiries to [email protected] or (888) 824 – 8111.

The pay range for this position is listed above. Exact compensation may vary based on several factors, including location, experience, and education. Benefit packages include medical, dental, and vision insurance, as well as 401k retirement account access. Employees in this role receive paid time off and may also be entitled to paid sick leave and/or other paid time off as provided by applicable law.