Large insurance company is looking for experienced RN Case Manager to work hybrid role of field/remote visits in IL. The hiring manager is looking for a IL licened RN local to Sangamon, Montgomery and Macoupin counties to work a great temp to hire position.

This client requires all employees to be vaccinated for COVID-19. Please be prepared to provide proof of vaccination upon hire.

Travel in Sagamon, Montgomery and Macoupin County is required for the position. Qualified candidate must have valid drivers license and reliable form of transportation.

Schedule: Monday-Friday 8am to 5pm CST

Job Duties: Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

• Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies
• Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.

Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality

• Reviews prior claims to address potential impact on current case management and eligibility
• Assessments include the member’s level of work capacity and related restrictions/limitations
• Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality
• Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management
• Utilizes case management processes in compliance with regulatory and company policies and proceduresRequired Qualifications:

- Minimum 3 years of clinical practice experience required.
- Current Active unrestricted RN licensure in the state of IL required.
- Willing and able to travel 50-75% of their time using their own vehicle to meet members face to face in Sangamon, Montgomery and Macoupin county.

Preferred Qualifications:
-Case Management in an integrated model preferred.
- Experience working with adults with Behavioral Health needs preferred.
- Long Term care experience in Nursing Home setting preferred

Job Types: Full-time, Contract

Pay: $30.00 - $36.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Medical specialties:

• Home Health

Schedule:

• Monday to Friday

Work setting:

• Hybrid remote
• Long term care
• Nursing home

Ability to commute/relocate:

• Springfield, IL: Reliably commute or planning to relocate before starting work (Required)

Experience:

• RN: 3 years (Required)
• Case management: 1 year (Required)

License/Certification:

• Illinois RN License (Required)

Work Location: On the road

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