Description:
? Remote work from home role anywhere in the US with virtual training,
? 8:30am - 5pm shift within time zone of residence,
? Telephonic case manager with patients and their care team,
? Application and/or interpretation of applicable criteria and clinical guidelines,
? Applies clinical judgment for risk factors and barriers,
? Consults with supervisor and others to overcome barriers,
? Utilizes motivational interviewing skills for member engagement,
? Identifies and escalates member?s needs appropriately,
? Performs medical necessity reviews.
Requirements: ? 5+ years? experience as a Registered Nurse with at least 1 year of experience in a hospital setting, ? Active, unrestricted license in state of residence, ? Willingness to receive multi-state/compact privileges, ? 1+ years? current or previous experience in Oncology, Transplant or Specialty Pharmacy, ? 1+ years? experience documenting electronically using a keyboard, ? 1+ years? Case Management experience or discharge planning, ? 1+ years' experience in Utilization Review, ? CCM and/or other URAC recognized accreditation preferred, ? 1+ years? experience with MCG, NCCN and/or Lexicomp, ? Bilingual in Spanish preferred.
Benefits:
? Affordable medical plan options,
? 401(k) plan (including matching company contributions),
? Employee stock purchase plan,
? No-cost programs for all colleagues including wellness screenings,
? Tobacco cessation and weight management programs,
? Confidential counseling and financial coaching,
? Benefit solutions that address different needs and preferences,
? Paid time off,
? Flexible work schedules,
? Family leave,
? Dependent care resources,
? Colleague assistance programs,
? Tuition assistance,
? Retiree medical access,
? Many other benefits depending on eligibility.
