5 Case Manager, RN, IN - Remote Jobs in Indiana, PA
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McLaren Health Care is Hiring a Remote Case Manager, RN, IN - Remote
We are looking for a Case Manager, RN to join us in leading our organization forward.
McLaren Integrated HMO Group (MIG), a division of McLaren Health Care Corporation, is an organization with a culture of high performance and a mission to help people live healthier and more satisfying lives.
McLaren Health Plan and MDwise, Inc., subsidiaries of MIG, value the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plans can thrive. As an employee MIG,you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
McLaren Health Plan is our Michigan-based health plan dedicated to meeting the health care needs of each of our Michigan members. Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
MDwise is our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs.Learn more about MDwise, Inc. at https://www.mdwise.org/
PositionSummary:
This position is responsible for care management functions.This includes but is not limited to the following: participates in the medical management of members in assigned product lines, including case specific and disease management programs, including catastrophic cases. Works with the PCP, the member and managementtopromotethedeliveryofqualityservicesatthemostappropriateand cost-effectivesetting.
This position is fully remote.
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
#LI-AK1
Qualifications:
Required:
- RNwithavalidunrestrictivelicensefromstateemployedin state providing services.
- Two(2)yearsclinicalnursingexperience.
- One (1) year previous case management or utilization review experience.
Preferred:
- Two (2) years’ experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions including understanding of claims administration, including CPT-4 codes, revenue codes, HCPCS codes, DRGs, etc.
Job Summary
Full Time
Ambulatory Healthcare Services
$78k-94k (estimate)
04/24/2024
04/30/2024
mclaren.org
DEWITT, MI
7,500 - 15,000
1914
$200M - $500M
Ambulatory Healthcare Services
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About McLaren Health Care
McLaren Health Care, headquartered in Grand Blanc, Michigan, is a $6 billion (budget FY21), fully integrated health care delivery system committed to quality, evidence-based patient care and cost efficiency. The McLaren system includes 15 hospitals in Michigan and Ohio, ambulatory surgery centers, imaging centers, a 490-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering approximately 640,000 lives in Michigan and Indiana, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malp...ractice insurance company. McLaren operates Michigans largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 51 National Cancer Institute-designated comprehensive cancer centers in the U.S. As part of its Graduate Medical Education (GME) program, McLaren maintains academic affiliations with medical schools at Wayne State University, Michigan State University and Central Medical University. McLarens six (6) GME campuses offer 27 residencies and eight (8) fellowship programs that train over 650 future physicians annually. All GME programs at McLaren are overseen and managed centrally by the Department of Academic Affairs.
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