Utilization Management RN - REMOTE (PA, NJ, DE)

Job Description

A large healthcare insurance company local to the Philadelphia area is looking for to hire a fully remote Case Management RN to join their Care management team.

Under the direction of a designated Care Management and Coordination Supervisor, performs telephonic or onsite review of hospital admissions, determining alternative settings when appropriate. Works to add value to healthcare by encouraging efficient and high quality use of the healthcare delivery system. Promotes timely and dynamic discharge planning to facilitate early discharge and refers cases to Case Management when indicated. Efficiently collaborates with the hospital utilization review department, attending physicians and members/families as appropriate.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com .

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Skills and Requirements

Active RN license - PA, NJ or DE

Must be comfortable working 100% remotely and have own equipment to work from home

3+ years of case management and utilization management experience

Post acute Care experience

Discharge planning and post acute care experience

Familiarity with NCQA and CMS standards null

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to HR@insightglobal.com.