Employer Industry: Specialty Health Management

Why consider this job opportunity:
- Salary up to $104,601
- Competitive benefits package including Paid Time Off, Medical, Dental, Vision, Short Term/Long Term Disability, and 401K with match
- Opportunity for career advancement and growth within the organization
- Work remotely with flexibility
- Engage in meaningful work that positively impacts patient health outcomes

What to Expect (Job Responsibilities):
- Analyze data to identify members in need of care navigation support to improve health outcomes and reduce costs
- Document clinical information and Social Determinants of Health (SDoH) for high-cost and high-utilization members
- Develop structured action steps for clinical staff using critical thinking and clinical assessment skills
- Participate in evaluating high-cost/high-utilizer and Transition of Care strategies
- Document accurately in Electronic Medical Records (EMR) and ensure timely reporting

What is Required (Qualifications):
- Bachelor's degree in nursing required
- Active, unrestricted RN license required; compact and/or multi-licensed preferred
- Minimum of 5 years of progressive experience in healthcare services, clinical operations, quality, or care management
- At least 3 years of clinical experience in a healthcare setting (Acute Care, Outpatient, etc.)
- Experience with cost of care initiatives aimed at decreasing admissions and readmissions

How to Stand Out (Preferred Qualifications):
- Certified Case Management (CCM) preferred
- Familiarity with HCPCs, CPTs, and ICD-10 coding preferred
- Experience with Medicare and Medicaid preferred
- Strong analytical skills and experience in clinical data analysis

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