Job Summary

This is a full-time position, Monday thru Friday during normal business hours. This position is 100% Remote, though you must reside in the state of Nevada, and have previous remote work experience.

We are seeking an experienced Registered Nurse (RN) with Pediatric Case Management (CM) experience in care planning and coordination of services. The CM is skillful in transition of care for health plan members throughout the health delivery system and acts as advocate as well as liaison between providers and members. Strong Case Management background in managed care is essential.
Job Duties include:
Facilitates the clinical progression of care and collaborates with health plan member, family and health plan and community providers.
Manages and prioritizes care coordination activities applies knowledge of complex care planning
Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care services
Identifies process improvement opportunities


Qualification

Qualifications and Skills
Graduate of an accredited program of nursing
Minimum of four years Case Management or acute care coordination experience
Experience in a Managed Care setting strongly preferred
Strong computer skills; proficient in Windows, Excel and prior use of a laptop
US Citizenship required
Must be able to pass security clearance
Active RN license in the state of Nevada
Job Type: Full-time


Licensure

Active RN license in the state of Nevada