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.