Grace Care Consulting is looking for an experienced, dedicated, and reliable RN CM for a full-time position with our client. This position is work from home with some occasional community-based work. RN must be located in one of the following counties: Bucks, Chester, Delaware, Montgomery and/or Philadelphia. Primary Responsibilities:

Make outbound/receive inbound calls to assess member’s current health status

Identify gaps or barriers in treatment plans

Provide patient education to assist with self-management

Interact with Medical Directors on challenging cases

Coordinate care for members

Make referrals to outside sources

Educate members on disease process

Document and track findings

Required Qualifications:

Bachelor’s degree or an Associate’s degree with RN license

Unrestricted licensure as a Registered Nurse

Current Licensure in the state of PA

Must be fully vaccinated against COVID 19

4+ years Case Management and/or Care Coordination experience

Background in managing populations with complex medical or behavioral health needs

Ability to prove technical knowledge of Microsoft Excel; ability to learn clinical applications quickly

Must have a designated workspace and access to secure high speed internet via cable/DSL in home

Current driver’s license, auto insurance, and ability to travel on occasional field visits to members/hospitals

Preferred Qualifications:

A background in Managed care

Certified Case Manager (CCM)

Experience in utilization review, concurrent review and/or risk management