HR Elements is hiring: Case Manager (RN) in Cincinnati

Department: 
Medical ManagementJob Title:
RN Case ManagerReports to:
Director, Medical Risk ManagementPosition Overview: This job description provides an overview of the role's general nature and responsibilities. It does not encompass a comprehensive list of all duties, responsibilities, and skills required for individuals in this classification.
As a Case Manager, you will be responsible for overseeing a designated group of employees/employers.  This role entails telephonic Case Management (CM) of at-risk individual members, along with management of care plans for high-cost members.   This position is onsite, located in Cincinnati.Key Responsibilities:

• Respond professionally, promptly, and comprehensively to both internal and external stakeholders.
• Perform Case Management for members from assigned companies, based on factors such as diagnosis, chronic conditions, and significant medical/pharmacy expenses. Identification of Case Management cases during pre-certification is essential. 
• Adhere to the guidelines set by the Case Management Society of America when documenting interactions and actions.
• Collaborate with Account Management, Stop Loss, Sales, and Operations teams to meet the needs of employees and employers effectively.
• Provide backup support to the Utilization Management RN when required.
• Fulfill any additional responsibilities as assigned.

Essential Qualifications:

• Minimum of 2 years of experience in Case Management; Case Management certification preferred.
• Valid RN licensure in either KY, OH or IN
• Background in clinical practice from a provider's perspective, with diverse clinical exposure, or from the payer side with CM experience.
• Proficiency in building rapport and establishing connections via phone communication.
• Strong record-keeping and reporting abilities.
• Capacity to manage the medical management portfolio for designated employers.
• Positive attitude and unwavering commitment to delivering exceptional customer service.
• Flourishes in an environment that embraces continuous improvement and adapts to change.
• Capable of both functioning as part of a team and advancing as an individual contributor.

Key Fundamentals: 1.  Take Care of Our Clients; 2.  Deliver Results; 3.  Be a Great Teammate; 4.  Be Positive and “Bring It”; 5.  Listen Generously; 6.  Be a Lifelong Learner; 7.  Align with Change

StrengthsFinder:  Achiever-E; Maximizer-I; Analytical-S; Communication-I; Positivity-R; Adaptability-R; Arranger-E; Learner-S; Developer-R; Restorative-E

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