Nurse Case Manager - Peoria, IL

TRIUNE Health Group is a nationally recognized managed healthcare company with over 35 years of experience. As a mission-driven, second-generation family-owned business, we are dedicated to improving lives by reducing the impact of injuries, enhancing health and wellness, and lowering healthcare and workers' compensation costs. At TRIUNE, we believe that every team member is essential to our success. We foster a supportive and collaborative environment where employees are valued, empowered, and provided with the tools they need to thrive—both professionally and personally.

The Nurse Case Manager coordinates resources and creates flexible cost effective options for catastrophically or chronically ill or injured individuals to facilitate quality individualized holistic treatment goals, including timely return to work when appropriate. This is a remote position; however, candidates must reside in the Peoria, IL area.

Provide medical case management to individuals through coordination with the patient, physicians, other health care providers, the employer and the referral source. Utilize the steps of Case Management to provide assessment, planning, implementation, evaluation and outcome of individual’s progress. Evaluate individual treatment plan for appropriateness, medical necessity, and cost effectiveness. Facilitates care such as negotiating and coordinating the delivery of durable medical equipment and home health services. Assess rehabilitation facilities for appropriateness of care, facilitate transportation, and coordinates architectural assessment of patients' home when required. Read extensively and stay current with medical terminology and the federal and state law relating to health care, Workers Compensation, ADA, HIPPA, FMLA, STD, LTD, SSDI, SSA. Utilize technology (computer, cell phone, fax and scanning machine) to prepare organized, timely reports while complying with safety rules and regulations in conjunction with HIPPA. Research medical and community resources for individuals with catastrophic or chronic diagnoses such as but not limited to AIDS, cancer, spinal cord injuries, diabetes, head injuries, back injuries, hand injuries, burns, etc Posses a valid driver’s license with the ability to travel 90% of the time. Perform other duties as assigned.