Health Plan Case Manager - RN

Michigan REMOTE - Seeking an experienced RN Medical Case Manager with medical case management experience, preferably within a health plan, managed care, or insurance environment. Candidates should have experience managing complex cases, engaging members telephonically/digitally, developing care plans, and meeting case management quality and production goals.

Job Responsibilities:

The Case Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs. They serve as the single point of contact for members, caregivers, and providers using a variety of communication channels including phone calls, emails, text messages and the online messaging platform. The Case Manager RN uses the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the member's health across the care continuum. They work in partnership with the member, providers of care and community resources to develop and implement the plan of care and achieve stated goals.

EDUCATION AND EXPERIENCE

REQUIRED:

• 3 years of clinical nursing experience

• ER, ICU, Med Surg

• Needs a diverse background, not one area

• Complex case manager experience to service members and meeting goals

• Medical Case Management

• Health plan Case Management

• Technology

• Dual Monitors and typing capability

• Excel, OneNote, Outlook, Teams, Word, etc.

• Manage multiple systems/tools, while simultaneously interacting with a member.

• Education/License/Certs

• Nursing Diploma or Associates degree in nursing

• Current, active, and unrestricted Michigan Registered Nurse license required

• Willing to obtain CCM within 18 mos if you do not have

• Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM).

PREFERRED:

• Bachelor's degree in nursing strongly preferred.
• 1 year of case management experience in a managed care setting strongly preferred.
• Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred.
• Certification in Case Management (CCM) preferred
• Certification in Chronic Care Professional (CCP) preferred

Why work with us? We are a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work with us you"ll have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! We are an EOE, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. https://www.optechus.com/eeo_self_identification/