Remote Anthem Nurse Case Jobs (NOW HIRING)

The RN Case Manager works with the clinical department and acts as a liaison with our physician practices. The RN Case Manager advocates for personalized treatment options that address a patient's unique care needs. The RN Case Manager has a patient-forward approach that is centered in the value-based care model, offers education and guidance for navigating complex medical decisions, and creates and manages the plan of care for patients with chronic or serious conditions.

What You Will Do

• You will be responsible for using your assessment and communication skills to engage with patients in need of clinical support to determine and prioritize their needs. You will deliver patient-centered care, provide exceptional customer service, and work within your scope of practice to provide evidence-based education, assessment, and care navigation.
• Identify patient/caregiver education needs through telephonic assessment/engagement and ensure that the patient/caregiver has adequate information to participate in the successful transition back to their home setting from an inpatient or post-acute facility stay.
• Conduct timely telephonic clinical outreach to identified patients.
• Collaborate with PCPs, NPs, and other members of the healthcare team to coordinate care for patients and actively help keep them stable at home.
• Serve as the point of contact and informational resource for patients, care teams, family/caregivers, payers, and community resources.
• Implement interventions that improve health outcomes, lower costs, and enhance the patient experience.
• Work collaboratively with provider offices, SNFs, hospitals, and other Clinical Services teams to support each patient's needs efficiently and effectively.
• Assist in coordination across the continuum of care while maintaining confidentiality.
• Guide patients through the healthcare system and help them overcome barriers.
• Coordinate treatment and services for patients.
• Schedule medical appointments as needed.
• Communicate about a patient's health condition with the patient and their family.
• Provide community resources to patients as needed and support resolution of Social Determinants of Health.
• Maintain a comprehensive working knowledge of community resources.
• Assume accountability for the quality of care.
• Continually seek new knowledge and learning that supports clinical care coordination.
• Depending on market location, minimal travel may be required to visit provider offices to help enhance provider office engagement (less than 5%).

What Will Make You Successful Here

• Must be located in the Kansas City, MO region preferably, or reside in Kansas.
• Bachelor's degree in Nursing preferred, or Associate's degree in Nursing with relevant experience.
• 5 years' experience as an RN or RN Case Manager providing complex care management.
• Minimum of 3 years' experience in Med Surg or Home Health.
• Experience providing Transitions of Care.
• Startup experience preferred.
• Unencumbered RN license, compact nursing license, or compact nursing license obtained within 6 months of hire.
• Accredited Case Manager (ACM) preferred.
• Comfortable and able to adapt to rapid changes.
• Excellent verbal and written communication skills.
• Excellent organizational skills and attention to detail.
• Entrepreneurial spirit, with a sense of ownership and comfort operating in ambiguity.
• Solution-oriented with the ability to think strategically and creatively in decision-making.
• Able to work independently and engage as part of a fully remote team.
• Coachable and able to take direction and feedback well, while also being forward-thinking to challenge the status quo.
• Comfortable providing care management using telehealth capabilities.
• Proficient with Microsoft Office Suite or related software.
• Ability to effectively and efficiently use various documentation tools and technological platforms, including EMRs; comfortable with digital technologies.
• Demonstrates a positive attitude and respectful, professional customer service.

Perks/Benefits

• Competitive base compensation.
• Annual bonus potential.
• Health benefits effective on start date
• Health & Wellness Program: up to $300 per quarter for your overall well-being, available on start date.
• 401(k) plan effective the first of the month after your start date; 100% match of up to 4% of your annual salary.
• Unlimited (or generous) paid "Vytal Time," and 5 paid sick days after your first 90 days.
• Company-paid STD/LTD.
• Technology setup.
• Opportunity to help build a market leader in value-based healthcare at a rapidly growing organization.

Disclaimer: Please Note: At no time during our screening, interview, or selection process do we ask for additional personal information (beyond your résumé) or account/financial information. We will also never ask you to purchase anything, nor will we ever interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com.