Remote Nurse Case Manager

Overview

• Manage member care plans, ensuring effective communication between members, families, and agencies.
• Coordinate covered and non-covered benefits for members, ensuring optimal service delivery.
• Conduct monthly member contact and follow-up to address identified needs.
• Participate in weekly team meetings to discuss member care strategies.
• Document member interactions thoroughly and timely in their charts.
• Utilize basic Excel skills for document management and data organization.
• Undergo initial onsite training for 90 days to familiarize with procedures.
• Work in a hybrid schedule with three days onsite and two days remote weekly.

Key Responsibilities & Duties

• Review and manage person-centered service plans with members and their families.
• Coordinate member care with vendor agencies to ensure comprehensive service delivery.
• Communicate effectively with members of diverse ages and socioeconomic backgrounds.
• Conduct clinical reviews and member assessments as required.
• Ensure compliance with documentation standards and timely record updates.
• Participate actively in team meetings to align on care strategies.
• Perform additional duties as necessary to support member care.
• Utilize Excel for data management tasks such as sorting and filtering documents.

Job Requirements

• Associate of Occupational Studies (AOS) degree required.
• Minimum of 1 year of experience in Managed Long-Term Care (MLTC).
• Proficiency in basic Excel functions including document management and data sorting.
• Strong communication skills to interact effectively with members and families.
• Ability to read, interpret, and apply clinical documentation and procedures.
• Experience in member assessment and clinical review processes preferred.
• Capability to work in a hybrid schedule with onsite and remote days.
• Bilingual candidates preferred for enhanced member communication.