Care Manager, Telephonic Nurse (Healthcare)

Location: Remote nationwide within the United States; candidates currently living in Puerto Rico cannot be hired. U.S. citizenship is required. Monday–Friday, 40 hours per week, with an 8-hour shift between 8:00 a.m. and 6:00 p.m. EST. Mandatory training during the first four weeks runs from 8:00 a.m. to 5:00 p.m. EST. Occasional travel to hirify.global offices for training or meetings may be required.

Salary: $71,100–$97,800 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare company providing insurance and healthcare services to Medicare, Medicaid, military personnel, families, individuals, and communities.

What you will do

• Provide comprehensive telephonic case management for the Special Populations program across the continuum of care.
• Apply specialized interventions to prevent or reduce hospital readmissions and support appropriate utilization of care sites and funding sources.
• Coordinate integrated care plans addressing beneficiaries’ clinical needs and conditions.
• Collaborate with care management programs, Military Treatment Facility utilization management and case management staff, physicians, and other providers.
• Serve as the primary point of contact for beneficiaries across the clinical spectrum.

Requirements

• U.S. citizenship is required under the Department of Defense contract.
• Interim approval for an NBIS government security clearance is required.
• Active RN license in the state of employment is required.
• At least two years of case management experience.
• At least three years of clinical RN or managed care RN experience.
• Ability to obtain CCM certification within one year of hire.

Nice to have

• Bachelor’s degree in nursing.
• TRICARE experience.
• Experience with MCG.
• Current CCM certification.

Culture & Benefits

• Remote work with equipment provided for telephone-based business requirements.
• Dedicated, interruption-free workspace required to protect member PHI and HIPAA information.
• Internet service should provide at least 25 Mbps download and 10 Mbps upload speeds.
• Medical, dental, and vision benefits, 401(k) retirement savings, paid time off, holidays, parental and caregiver leave, disability coverage, and life insurance.
• Employees working from home in California, Illinois, Montana, or South Dakota receive a bi-weekly internet expense payment.