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Anchored in our brand ? with heart at its center ? our purpose sends a personal message that how we reputed company our services is just as important as reputed company reputed company. Our Heart At Work Behaviors? support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to reputed company and reputed company solutions to reputed company health care more personal, convenient and reputed company. This is a full-time reputed company position. Hours for this role are Monday-Friday 8a-5p in time zone of residence. Position reputed company The dedication of... talented and caring health care professionals drives the delivery of high reputed company, cost effective products and services. They reputed company it possible for members to get the right health care treatment for their needs ? and for reputed company to reputed company its competitive edge. 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Develops a proactive course of reputed company to address issues presented to enhance the short and long-term reputed company as reputed company 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. reputed company Components 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 reputed company as smooth transition to reputed company programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address reputed company health and reputed company indicators which reputed company planning and reputed company of member issues. Assessments take into account information from various sources to address reputed company conditions including co-morbid and multiple diagnoses that reputed company functionality. Reviews prior claims to address potential reputed company on reputed company case management and eligibility. Assessments include the member?s level of work reputed company and reputed company 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 reputed company to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Required Qualifications ? reputed company and unrestricted RN licensure in state of residence ? 5+ years of clinical experience Preferred Qualifications ? Case Management in an integrated model Education ? Associate's Degree minimum Pay reputed company The typical pay reputed company for this role is $58,760.00 - $125,840.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. In reputed company to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. reputed company offers a full reputed company of medical, dental, and reputed company benefits. Eligible e Apply To This Job