Case Management Coord II (Must be a RN)

At CareAllies , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

# Job Summary
(Heb Nicu Um/Cm Nursethis Position Is Responsible For Performing Concurrent Review In Accordance With Accepted Department Criteria; Performing Discharge Planning And Identifying Alternate Treatment Programs That Provide Medically Necessary Potentially Cost Effective Services. Consulting With Physicians, Providers, Members, And Other Resources, As Appropriate, To Assess, Plan, Facilitate Implementation, Coordinate, Monitor, And Evaluate Options And Services Required To Meet An Individuals Health Needs, Using Communication And Available Resources To Promote Quality, Cost Effective Outcomes. Serving As Liaison To Physicians, And Members; Serving As Preceptor For Less Experienced Staff. This Position Will Perform Face To Face Visits In San Antonio And Provide Telephonic Support For All Other Locations. Ability And Willingness To Travel Within Assigned Location.
JOB REQUIREMENTS:

*Register Nurse (RN) with current, valid, unrestricted license in state of operations or reciprocity.

*2 years of clinical experience of direct clinical care to the consumer.

*1 year experience in health insurance/managed care.

*Customer Service oriented.

*PC proficiency to include Word, Excel, Lotus Notes and database experience.

*Clear and concise verbal and written communication skills.

*Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management.

Multi-state license fees will be provided by HCSC.

Incumbents with other clinical licenses are not required to obtain multi-state licenses.

PREFERRED JOB REQUIREMENTS:

*3 years clinical experience.

*Medicare knowledge a plus

*Experience in Disease Management.

*Experience in managing complex or catastrophic cases.

*Working toward CM certification or Advanced degree.

*Knowledge of medical management policies and procedures.

*Bilingual in Spanish/English or Polish/English (not required but a plus)

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii .

EEO Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Pay Transparency Statement:

At CareAllies, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, a minimum of 15 days’ of paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for full-time employees .

The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Min to Max Range:
$69,800.00 - $125,900.00

Exact compensation may vary based on skills, experience, and location.