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Remote Nurse Case Manager
locations
Portland, OR
Remote, USA
time type
Full time
job requisition id
REQ003123
At The Standard, you’ll join a team focused on putting our customers first.
Our continued success is driven by a high-performance culture. We’re looking for people who are collaborative, accountable, creative, agile and are driven by a passion for doing what’s right across the company and in our local communities.
We offer a caring culture where you can make a real difference, every day.
Ready to reach your highest potential? Let’s work together.
JOB PURPOSE
Assess claimants’ medical conditions, diagnostics, procedures performed and ongoing treatment to determine functional capacity levels as well as the appropriateness of care. Collaborate with treating physicians to promote suitable care plans directed toward return to work by communicating with claimants, treating and consulting physicians, employers and benefits personnel. Assess medical record documentation for completeness. Coordinate claim prevention, intervention and return to work programs for employers.
PRINCIPAL ACCOUNTABILITIES / ESSENTIAL FUNCTIONS
Contribute to the company’s success through excellent customer service and meeting or exceeding performance objectives for the following major job functions:
<ul>
<li>Evaluate medical history and treatment and test results during file reviews and consultations with division benefits staff. Provide assessments of claimants’ functional capacity and their levels and expected durations of impairment. Identify and resolve stated limitations inconsistent with medical documentation. Assess medical records to determine if claim for disability is caused or contributed to by a limited or excluded medical condition.</li>
<li>Assess adequacy and appropriateness of treatment. Advocate on behalf of the claimant for appropriate services and treatment to attain maximum medical improvement and successful return to work. Work in conjunction with vocational and benefits staff to assess claimants’ psychosocial, environmental and financial status. Communicate with claimants, their families, employers, medical treatment providers, rehabilitation counselors and other carriers such as workers’ compensation providers or HMO’s, to ensure understanding of and cooperation with the recommended treatment plans and the goal of returning to work.</li>
<li>Provide claim prevention services by working with employers to evaluate their organizations’ trends in disabilities. Coordinate site visits and assessments; advise on educational programs for employee groups; work in conjunction with vocational staff to recommend job site modifications and safety or procedural changes. Collaborate with sales, underwriting, and vocational and benefits staff to recommend, develop and implement intervention and return to work programs and practices for employers.</li>
<li>Develop and conduct medical education and training for division claims personnel.</li>
</ul>
ESSENTIAL FUNCTION REQUIREMENTS
Demonstrated skills: Effective case management. Effective identification and resolution of problems. Clear and persuasive expression of ideas in both written and oral communications. Effective collaboration with peers and team members.
Ability to: Utilize computer software and hardware applications. Talk by telephone. Shift priorities to meet demands from various customer groups. Make decisions in the absence of specific direction. Facilitate group discussions. Achieve professional designation.
Working knowledge of: Assistive devices needed by people with disabilities. The Americans with Disabilities Act, family leave laws, Fair Claims Settlement Practices Act, and laws governing client confidentiality.
QUALIFICATIONS
Education: BS or MS in a related field.
Experience: A minimum of 4 years hospital or clinical experience in relevant medical fields (e.g. cardiology, orthopedics, mental health) or utilization review or quality management, or the equivalent combination of education and/or relevant experience.
Professional certification required: Current Registered Nursing license, with a CCM or CPDM designation or ability to obtain such a designation within 2 years of hire. Is a job requirement
#LI-REMOTE
Note:&nbsp;The Standard is required to provide a reasonable estimate of the salary for this role when hiring a Colorado resident. The salary for employees working in Colorado in this role is listed below. The Standard’s package also includes incentive plan participation&nbsp;and comprehensive benefits&nbsp;including medical, dental, vision, retirement, and paid time off.
<ul>
<li>Please note, eligibility to participate in an incentive program is subject to the rules governing the program and plan. Any award depends on various factors, including individual and organizational performance.</li>
</ul>
Salary Range:
$62,000.00 – $93,900.00
Standard Insurance Company, The Standard Life Insurance Company of New York, Standard Retirement Services, Inc., StanCorp Equities, Inc. and StanCorp Investment Advisers, Inc., marketed as The Standard, are Affirmative Action/Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, religion, color, sex, national origin, gender, sexual orientation, age, disability, or veteran status or any other condition protected by federal, state or local law. The Standard offers a drug and alcohol free work environment where possession, manufacture, transfer, offer, use of or being impaired by an illegal substance while on Standard property, or in other cases which the company believes might affect operations, safety or reputation of the company is prohibited. The Standard requires a criminal background investigation, drug test, employment, education and licensing verification as a condition of employment. All employees of The Standard must be bondable.

Nurse Case Manager at The Standard - StanCorp Financial Group

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Case Coordinator
locations Remote – US
time type Full time
job requisition id R29675
Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.
Case Coordinator
Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.
Work Location: Remote US
Position:
Responds to in-bound, routine customer telephone inquiries regarding products, services, order status, and other general questions. Typically uses scripted dialogue and may escalate inquiry to product support, billing, sales or return/repair. Logs calls and updates customer account records. At higher levels, may be asked to provide responses to submitted questions throughout-bound calling.
Core Responsibilities:
<ul>
<li>Achieve daily, weekly, and monthly quality and production goals.</li>
<li>Adhere to call handling process.</li>
<li>Adhere to call quality standards by ensuring proper phone etiquette and adherence to scripts, make accurate and descriptive MMS documentation.</li>
<li>Follow-up with members as assigned.</li>
<li>Adhere to assigned schedule.</li>
<li>Completion of all Change Healthcare required courses on University (CHU).</li>
<li>Review all correspondence sent by Change Healthcare and management with current information of state and federal regulatory requirements.</li>
<li>Review all correspondence sent by Change Healthcare and management with updates on the organization.</li>
<li>Comply with all company and department operational guidelines and policies.</li>
<li>Participate in Change Healthcare staff and operational development programs as assigned.</li>
<li>Performs other duties as assigned</li>
</ul>
Requirements:
<ul>
<li>Bilingual (English/Spanish).</li>
<li>3-year External Customer Service/Call Center Internal 3 years</li>
<li>Education: High School Diploma or Equivalent</li>
<li>Excellent Problem-solving skills</li>
<li>Excellent Time Management</li>
<li>Business demeanor and skills with the ability to communicate effectively (verbal, written and listening skills).</li>
<li>Promote company services in an outbound call center (production driven) environment.</li>
<li>Professional behavior with courteous, polite, and energetic qualities.</li>
<li>High commitment to accuracy, high quality work, and detail oriented.</li>
<li>Must be driven and motivated to exceed individual and team goals.</li>
</ul>
Preferred Qualifications:
<ul>
<li>Excellent data entry and internet navigation skills</li>
<li>Ability to work independently.</li>
<li>Demonstrates patience and empathy.</li>
<li>Maintain a confident, helpful, and positive tone on all calls</li>
<li>High commitment to accuracy, high quality work, and detail oriented.</li>
<li>Must be driven and motivated to exceed individual and team goals.</li>
<li>Able to learn and adapt to changing environments, applications, and software.</li>
<li>Basic knowledge of Microsoft Team, Word, Excel, and PowerPoint.</li>
</ul>
Working Conditions/Physical Requirements: information.
<ul>
<li>General office demands</li>
<li>This is a remote position. Required to have a dedicated work area established that is separated from other living areas and provides information privacy.</li>
<li>Must live in a location with internet connection.</li>
</ul>
Unique Benefits*:
<ul>
<li>Flexible work environments</li>
<li>Ready, Set, Grow Career Development Center &amp; access to Change Healthcare University for continuous professional learning &amp; development with more than 5,000 training assets</li>
<li>Volunteer days, employee giving and matching gifts programs, community awards and dollars for doers, community partnerships</li>
<li>Employee wellbeing programs and generous health plans</li>
<li>Educational assistance programs</li>
<li>US 401(k) or Group RRSP (Canada) savings plans with matching employer contributions</li>
<li>Be sure to ask our Talent Advisors for more information on location specific benefits and paid time off policies</li>
<li>Learn more at https://careers.changehealthcare.com</li>
<li>*Eligibility for some benefits may be limited or not available for part-time employees, be sure to speak with your Talent Advisor.</li>
</ul>
Diversity and Inclusion:
<ul>
<li>At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.</li>
<li>Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace.</li>
</ul>

Case Coordinator at Change Healthcare

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Telephonic Nurse Case Manager
REMOTE
Job Type
Full-time
Description
A Telephonic Nurse Case Manager is responsible for providing telephonic medical case management for Worker’s Compensation and Liability Injury Management programs. Case Management is a collaborative process to promote quality cost effective outcomes, which enhance the physical, psycho-social, and vocational health of individuals. This includes assessing, planning, implementing, coordinating, and evaluation of service options. The goal of the Case Manager is to assist the injured worker in receiving appropriate, cost effective medical care for their injury in a timely manner, and to expedite their return to work.
Position Logistics: Non-Exempt, Full-time, eight (8) hour work day, Monday – Friday, Travel may be required.
Please note: This position requires a compact RN license and NY state RN license in good standing (or ability to acquire NY state RN license)
Responsibilities may include, but are not limited to:
<ul>
<li>Once a file is identified as needing a Telephonic Case Manager, the TCM ensures telephonic case management activities are processed in accordance with EK’s standard. Activities may include:</li>
</ul>
o Completing referrals within computer database from either injury report or information gathered from the web-based system
o Performs 3-point contact on new files and, depending on account, forwards within 24 or 72 hours from date of referral
o Reviewing and evaluating all medical correspondence and provider reports obtained to determine work status of IWs or patients
o Reviewing treatment plan history and direction of file with client, when necessary
o Providing a 24-hour update after all significant activity
o Evaluating clinical status of claimant and researches for alternative options to treatment as warranted
o Communicating with the claim’s examiners regarding directives, and provides updates on file status
o Arranging transportation services when necessary and authorized
o Evaluating therapy facilities and their progress on specific cases
o Preparing comprehensive notes following any discussions had with IW, medical providers, claims examiners, and employers in the case file in EK TCM Ahshay and client system, per policy standards and procedure
o Completes initial reports every 14 days and every 30 days thereafter, according to account profile and service type.
o Ability to handle a variable case load dependent on service and client type
<ul>
<li>Utilizes the nursing process in conjunction with URAC standards, EK Standards and client guidelines to manage and move files forward.</li>
</ul>
o Assessment:
§ Perform a complete nursing evaluation
§ Collect relevant data to the patient’s physical and mental status, functional capability, personal and environmental factors
§ Analyze the collected data to determine problems, strengths and needs of the patient
o Planning:
§ Discuss the analyzed data and the comprehensive plan of care with the insurance representative prior to implementation
§ Upon authorization, implement this plan of care with patient, physician and health care providers
o Implementation:
§ Make regular personal contact to oversee the contracted services in order to maintain quality of care
§ Arrange for care/services as needed (home care, procedures, medication, equipment or supplies)
§ Monitor the plan of care with modifications or changes suggested to the patient and physician as the need arises
§ Coordinate information between all parties (injured worker, physicians, employer, other providers, such as therapists, and attorney, if any is involved)
o Evaluation:
§ Determine the progress and the effectiveness of the care
§ Prepare a monthly report of the patient’s progress and specific cost savings
§ Evaluating clinical files ongoing and ensuring care is medically necessary
<ul>
<li>Accurately and efficiently identifying properly requested files for Triage and processes for determination of telephonic or field case management.</li>
<li>Evaluating clinical files ongoing and ensuring care is medically necessary</li>
<li>Identifying cases that are not utilizing the MPN or PPO network providers, and appropriately redirects IW to the network providers</li>
<li>Ensuring productivity and timeliness of reviews follow EK and client departmental policies, standards and procedures</li>
<li>High level of comfort with computer based activities including typing, managing all activities within a web based platform and leveraging technology to attend visits or assessments virtually, when appropriate, by means such as Zoom, Facetime and telemedicine platforms.</li>
<li>Identifying and recommending referrals to Field-Based Case Management and EK Specialty Programs.</li>
<li>Handling all medical information and reports as confidential information, ensuring accuracy of files and notepad entries</li>
<li>Attending in-service meetings and continuing education seminars, as appropriate</li>
<li>Utilizing effective oral communication, written communication and organization skills and demonstrates the ability to prioritize case activities</li>
<li>Professional interaction with EKHS staff, members of the medical community, and all customers of EKHS; both in oral and written forms</li>
<li>All work is done within the scope of practice for a Registered Nurse in in the state where case management services</li>
<li>May act as preceptor for new or covering Telephonic Case Managers as requested by management</li>
<li>Participate in EKHS Nursing teleconferences and staff meetings as scheduled.</li>
<li>Adherence to EKHS Employee Handbook</li>
<li>Other duties as assigned</li>
</ul>
Requirements
Qualifications:
<ul>
<li>Graduate of an accredited school of nursing</li>
<li>Valid state-appropriate RN license in good standing with no restrictions</li>
<li>Compact RN License</li>
<li>May be required to obtain additional state RN licenses (NY)</li>
<li>Possesses and can demonstrate the professional and technical skills needed</li>
<li>Experience in Field or Telephonic Case Management, Workers’ Compensation or Liability experience highly preferred, but not required</li>
<li>Experience in Home Health Care, Occupational Health considered a plus</li>
<li>Certified Case Manager (CCM), Certified Occupational Health Nurse (COHN or COHN-S) or Certified Rehabilitation Registered Nurse (CRRN) highly preferred, but not required.</li>
<li>High comfort level with computers and computer programs (MS Word, MS Excel, Email)</li>
<li>Excellent Written and Oral Communication Skills</li>
<li>Excellent Interpersonal Skills</li>
<li>Strong Organization Skills</li>
<li>High comfort level with computers and computer programs (MS Word, MS Excel, Email)</li>
<li>Ability to work independently with minimal supervision</li>
<li>Ability to meet deadlines in a high pressure, time sensitive environment</li>
<li>Ability to lift up to 20 lbs</li>
</ul>
Physical Requirements: Candidate must be able to sit the majority of an 8-hour day except for lunch and break times. Candidate must be able to keyboard the majority of an 8-hour day except for lunch and break times. Candidate must have manual dexterity. Candidate must be able to speak on the telephone intermittently throughout the day. Candidate must be able to read and write English fluently. Candidate must be able to provide and confirm safe home office environment. Home office must be HIPAA compliant.
*Requires DSL, fiber, or cable internet connection from home 10 mbps preferred or better *

Telephonic Nurse Case Manager at EK Health Services

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RN Case Manager – Remote
Remote
The Role:
We are looking for passionate and experienced RNs to provide clinical oversight and direction to our Field Providers and Case Management Teams to ensure quality care for our longitudinal populations.
The Company:
At MedArrive our mission is to improve lives by bringing more humanity to healthcare.
MedArrive enables healthcare providers to seamlessly extend care services into the home, unlocking access to high-quality healthcare for more people at a fraction of the cost. MedArrive’s care management platform allows providers and payers to bridge the virtual care gap, integrating physician-led telemedicine with in-person care from EMS professionals. Patients can access trusted medical expertise from their homes’ comfort and safety without interruption to the continuity of care, ultimately resulting in better patient outcomes, a better-utilized healthcare workforce, and significant cost savings for patients and providers alike. MedArrive has more than 50k highly-skilled EMS providers in its national network, and services span dozens of clinical use cases, including urgent care, complex condition monitoring, and medication administration.
This is a 100% remote role that can be based anywhere in the United States or its territories.&nbsp;Preference will be given to candidates who maintain, demonstrably strong connections in the Texas healthcare market.
Responsibilities:
<ul>
<li>Provide oversight through chart review to ensure quality, holistic care</li>
<li>Collaborate with Clinical Team and provide triage to prioritize interventions</li>
<li>Daily Monitoring of patient panel to provide feedback to team to make certain performance meets competency metrics while delivering compassionate care</li>
<li>Identify gaps in resources and solutions to address these gaps</li>
<li>Present the data obtained for discussion with cross functional teams</li>
<li>Strategize to improve care delivery model and streamline workflows</li>
<li>Identify opportunities for expansion of our Care Programs to present to our Demand Partners</li>
<li>Work as a collaborative partner to our Demand Partners</li>
<li>Synthesize reporting to our Sr. Director of Population Health to inform on both clinical and SDoH dirven needs of patient panel</li>
<li>Assist with the Development of our Care Delivery Policies and Procedures</li>
</ul>
Minimum Requirements
<ul>
<li>Registered Nurse</li>
<li>3 – 5 years’ Clinical Experience</li>
<li>Must have an Current Unrestricted License to Practice as a Registered Nurse</li>
<li>Ability to communicate and interact with Senior Leadership and external executive audiences.</li>
<li>Excellent written, oral, and interpersonal skills.</li>
<li>In-depth knowledge of current standard of medical practice</li>
</ul>
Preferred Requirements
<ul>
<li>Texas licensure</li>
<li>Certified Case Manager (CCM)</li>
<li>BSN</li>
<li>Discharge Planning Experience</li>
<li>Home Health Care Coordination Experience</li>
</ul>
Skills &amp; Abilities
<ul>
<li>Energy and enthusiasm consistent with working for a startup; ability to self-teach in order to problem solve, takes initiative.</li>
<li>Strong critical thinking, creative problem solving, judgment, and client management skills.</li>
<li>Ability to maintain confidentiality, tact, and diplomacy.</li>
<li>Ability to incorporate feedback from daily operations to improve the care program model.</li>
<li>Ability to critically analyze and synthesize the data received from patient panel to improve the care we deliver and present to cross functional teams</li>
<li>Ability to work strategically while implementing our care programs in real time</li>
</ul>
This is a 100% remote role that can be based anywhere in the United States or its territories.&nbsp;Preference will be given to candidates who maintain, demonstrably strong connections in the Texas healthcare market.
*At MedArrive we believe in the value of diverse experiences. If you think you meet some of the qualifications, but don’t necessarily check every box in the job description, we encourage you to still apply. Your experience matters.
**At MedArrive we take multiple data points into consideration when calculating our opening base salary offers. While every effort is made to extend an equitable offer the first time, every time, we know that as humans we have the potential to fall short. Studies show that women and underrepresented people are less likely to negotiate their compensation. We encourage all applicants to feel comfortable articulating their unique value during salary negotiating conversations, every time.

Registered Nurse Case Manager at MedArrive

RN Case Manager – Remote
Remote
The Role:
We are looking for passionate and experienced RNs to provide clinical oversight and direction to our Field Providers and Case Management Teams to ensure quality care for our longitudinal populations.
The Company:
At MedArrive our mission is to improve lives by bringing more humanity to healthcare.
MedArrive enables healthcare providers to seamlessly extend care services into the home, unlocking access to high-quality healthcare for more people at a fraction of the cost. MedArrive’s care management platform allows providers and payers to bridge the virtual care gap, integrating physician-led telemedicine with in-person care from EMS professionals. Patients can access trusted medical expertise from their homes’ comfort and safety without interruption to the continuity of care, ultimately resulting in better patient outcomes, a better-utilized healthcare workforce, and significant cost savings for patients and providers alike. MedArrive has more than 50k highly-skilled EMS providers in its national network, and services span dozens of clinical use cases, including urgent care, complex condition monitoring, and medication administration.
This is a 100% remote role that can be based anywhere in the United States or its territories. Preference will be given to candidates who maintain, demonstrably strong connections in the Texas healthcare market.
Responsibilities:
<ul>
<li>Provide oversight through chart review to ensure quality, holistic care</li>
<li>Collaborate with Clinical Team and provide triage to prioritize interventions</li>
<li>Daily Monitoring of patient panel to provide feedback to team to make certain performance meets competency metrics while delivering compassionate care</li>
<li>Identify gaps in resources and solutions to address these gaps</li>
<li>Present the data obtained for discussion with cross functional teams</li>
<li>Strategize to improve care delivery model and streamline workflows</li>
<li>Identify opportunities for expansion of our Care Programs to present to our Demand Partners</li>
<li>Work as a collaborative partner to our Demand Partners</li>
<li>Synthesize reporting to our Sr. Director of Population Health to inform on both clinical and SDoH dirven needs of patient panel</li>
<li>Assist with the Development of our Care Delivery Policies and Procedures</li>
</ul>
Minimum Requirements
<ul>
<li>Registered Nurse</li>
<li>3 – 5 years’ Clinical Experience</li>
<li>Must have an Current Unrestricted License to Practice as a Registered Nurse</li>
<li>Ability to communicate and interact with Senior Leadership and external executive audiences.</li>
<li>Excellent written, oral, and interpersonal skills.</li>
<li>In-depth knowledge of current standard of medical practice</li>
</ul>
Preferred Requirements
<ul>
<li>Texas licensure</li>
<li>Certified Case Manager (CCM)</li>
<li>BSN</li>
<li>Discharge Planning Experience</li>
<li>Home Health Care Coordination Experience</li>
</ul>
Skills &amp; Abilities
<ul>
<li>Energy and enthusiasm consistent with working for a startup; ability to self-teach in order to problem solve, takes initiative.</li>
<li>Strong critical thinking, creative problem solving, judgment, and client management skills.</li>
<li>Ability to maintain confidentiality, tact, and diplomacy.</li>
<li>Ability to incorporate feedback from daily operations to improve the care program model.</li>
<li>Ability to critically analyze and synthesize the data received from patient panel to improve the care we deliver and present to cross functional teams</li>
<li>Ability to work strategically while implementing our care programs in real time</li>
</ul>
This is a 100% remote role that can be based anywhere in the United States or its territories. Preference will be given to candidates who maintain, demonstrably strong connections in the Texas healthcare market.
*At MedArrive we believe in the value of diverse experiences. If you think you meet some of the qualifications, but don’t necessarily check every box in the job description, we encourage you to still apply. Your experience matters.
**At MedArrive we take multiple data points into consideration when calculating our opening base salary offers. While every effort is made to extend an equitable offer the first time, every time, we know that as humans we have the potential to fall short. Studies show that women and underrepresented people are less likely to negotiate their compensation. We encourage all applicants to feel comfortable articulating their unique value during salary negotiating conversations, every time.

Remote case Jobs.

Nurse Case Manager at The Standard - StanCorp Financial Group →

The Standard - StanCorp Financial Group

Case Coordinator at Change Healthcare →

Change Healthcare

Telephonic Nurse Case Manager at EK Health Services →

EK Health Services

Registered Nurse Case Manager at MedArrive →

MedArrive

Registered Nurse Case Manager at MedArrive →

MedArrive