Registered Nurse (RN) - Case Manager - Medical Management
Avera
- Sioux Falls, SD
- Permanent
- Full-time
- Paid Time Off (PTO) available on Day 1!
- Options for Free Health Insurance!
- This position has the opportunity to work remotely!
- Positive Work Environment: Be part of an organization where we practice the mission in our daily operations and demonstrate our pride by delivering excellent care.
- The RN Case Manager is a specialized nurse that identifies members who would benefit from complex/chronic condition case management and/or service coordination.
- The RN Case Manager develops and facilitates the member’s plan of care. In collaboration with physicians, population health staff, employers, community organizations, hospital-based case managers/utilization review staff, clinic-based care coordinators/preauthorization staff, and Insurance Division staff, the RN Case Manager encourages the best possible outcome in the most cost effective manner in accordance with standards set forth by National Committee for Quality Assurance (NCQA).
- The RN Case Manager will need to be knowledgeable in various aspects of all health plan lines of business, inclusive of commercial, marketplace, and self-funded clients.
- The position requires interaction with health system stakeholders, key opinion leaders, vendors, delegated entities, healthcare providers, policy makers, and accreditation and government organizations.
- Graduate from an accredited RN program (Associate’s degree or Bachelor of Science degree).
- Four years of professional nursing practice experience preferably in the acute care setting.
- Case-management, disease-management, care coordination or equivalence preferred.
- Proficient in Microsoft Word, Excel, Access and Power Point. Familiarity with data extraction tool is desirable.
- Licensed as a Registered Nurse in the state of South Dakota and/or meeting the requirements of the enhanced Nursing Compact Licensure (eNCL) required.
- Registered Nurse in the state of Minnesota or within 120 days of employment required.
- Certification in Case Management, Managed Care Nursing or a related specialty to be completed within 2 years of hire date.
- Monday - Friday; 80 hours every 2 weeks
- 8:00 am - 5:00 pm
- $29.50- $44.25 per hour