Remote Rn Insurance Assessment Jobs in Ann Arbor, MI

Position Details:
Job Title: Remote RN Case Manager
Location: 100% Remote
Duration: 12 Months
License Required: Michigan State RN License

ESSENTIAL DUTIES AND RESPONSIBILITIES (Other duties may be assigned.)

• Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs telephonically and/or digitally. The multidisciplinary team includes Medical and Behavioral Health Social Workers, Registered Dietitians, Pharmacists, Clinical Support Staff, and Medical Directors.
• Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize members' health across the care continuum.
• Assess the member's health, psychosocial needs, cultural preferences, and support systems.
• Engage the member and/or caregiver to develop an individualized plan of care, address barriers, identify gaps in care, and promote improved overall health outcomes.
• Arrange resources necessary to meet identified needs (e.g., community resources, mental health services, substance abuse services, financial support services, and disease-specific services).
• Coordinate care delivery and support among member support systems, including providers, community-based agencies, and family.
• Advocate for members and promote self-advocacy.
• Deliver education on health literacy, self-management skills, medication plans, and nutrition.
• Monitor and evaluate the effectiveness of the care management plan, assess adherence to the care plan to ensure progress toward goals, and adjust and reevaluate as necessary.
• Accurately document interactions that support the management of the member.
• Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care.
• Educate the member and/or caregiver about post-transition care and required follow-up, summarizing what occurred during an episode of care.
• Secure durable medical equipment and transportation services and communicate this information to the member and/or caregiver and key individuals at the receiving facility or home care agency.
• Adhere to professional standards, protocols, rules, and guidelines while meeting quality and production goals.
• Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM) certification.

EDUCATION AND EXPERIENCE

• Nursing Diploma or Associate Degree in Nursing required.
• Bachelor's Degree in Nursing strongly preferred.
• Minimum of 3 years of clinical nursing experience in clinical, acute/post-acute care, and community settings required.
• Minimum of 1 year of case management experience in a managed care setting strongly preferred.
• Experience managing patients telephonically and through digital channels (mobile applications and messaging) preferred.

CERTIFICATES, LICENSES, AND REGISTRATIONS

• Current, active, and unrestricted Michigan Registered Nurse (RN) license required.
• Certification in Case Management (CCM) preferred.
• Certification as a Chronic Care Professional (CCP) preferred.

QUALIFICATIONS

• Ability to perform each essential duty successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

OTHER SKILLS AND ABILITIES

• Ability to think critically, make decisions, and solve a variety of issues that may impact member outcomes.
• Empathetic, supportive, and an effective listener.
• Proficient in motivational interviewing techniques.
• Demonstrated time management skills.
• Strong organizational skills with the ability to manage multiple systems and tools while simultaneously interacting with members.
• Intermediate computer proficiency, including Microsoft Excel, OneNote, Outlook, Teams, Word, and other Microsoft Office applications.
• Ability to work collaboratively in a team environment as well as independently.
• Excellent written and verbal communication and interpersonal skills.

Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.

At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.

Kyyba is an Equal Opportunity Employer.

Kyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b