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IPMG logo
IPMG

The International Press and Media Group

Nurse Case Manager

ManagerManagerFull TimeRemoteMid LevelTeam 201-500Since 2007H1B No SponsorCompany SiteLinkedIn

Location

Illinois

Posted

59 days ago

Salary

$87K - $112K / year

Seniority

Mid Level

Bachelor Degree2 yrs expEnglish

Job Description

Nurse Case Manager

IPMG

• Conducts initial and ongoing assessments to identify patient status and individual needs; promotes client self-determination • Assists in identifying appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source. • Utilizes appropriate resources and case management interventions to facilitate the case management plan and to allow for the individual’s optimum level of wellness and functional capability with quality cost-effective outcomes appropriate to health plan and workers’ compensation • Develops a specific case management plan in collaboration with the consumer and members of the health care team with periodic updates. • Identifies short term goals, long term goals, interventions to meet goals, resources to be utilized, timeframes for re-evaluations, and collaborative approaches to facilitate the case management plan • Executes and documents specific case management activities and/or interventions that will lead to accomplishing the goals set forth in the case management plan • Gathers sufficient information from all relevant sources and its documentation regarding the case management plan and its activities and/or services to enable the determination of the plan’s effectiveness • Evaluates at appropriate intervals, determining and documenting the case management plan’s effectiveness in reaching desired outcomes and goals with modifications, as appropriate • Measures and modifies the interventions to determine the outcomes of the case management involvement • Implements care plan by facilitating authorizations and referrals, as appropriate, within benefit structure, contractual agreements or jurisdictional regulations; utilizing nationally accepted evidence based criteria as guidelines for treatment protocols • Documents all contacts according to Best Practices, utilizing templates, as required • Notifies claims personnel regarding anticipated surgeries, benefit exceptions, and other significant events that may require special handling • Manages the disability durations proactively, utilizing nationally accepted evidence based criteria as guidelines for duration protocols in workers’ compensation and short term disability • Collaborates and communicates effectively with patients/injured workers, providers, client, employers, and internal team members • Performs triage intake functions with referrals and coordination of care needs specific to client instructions. • Performs leave administration and short term disability management according to regulations, policies, and plan documents

Job Requirements

  • Current registered nurse (RN) License
  • 2 years of clinical experience
  • Excellent written and verbal communication skills
  • Proven customer service skills
  • Effective time management skills
  • Overall computer proficiency including expertise in Microsoft Office Suite, especially Outlook, Word, and Excel
  • Licensure or certification in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice of the discipline.
  • Two years full-time equivalent of direct clinical care to the consumer;
  • Certification as a case manager from the URAC-approved list of certifications; or A bachelor’s or higher degree in a health or human services related field; or A current registered nurse (RN) license
  • Willingness to obtain advanced certification, when eligible
  • Willingness to obtain additional state licensure, as required by business needs.

Benefits

  • Generous Time off
  • You'll start with 20 days of PTO, paid holidays, paid Birthday off
  • Medical, dental, and vision coverage on day one of full-time employment, including telemedicine if you are on our medical plan
  • 401k match
  • Professional development support and a Linkedin Learning subscription
  • Flexible time off with an encouraged time away to support a healthy work-life balance
  • Life Insurance, Short term, and long-term disability on day one of full-time employment and paid for by IPMG
  • Onsite fitness center and showers, in our St. Charles, IL HQ office

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