Remote Nurse Case Manager (Payer/Insurance Experience Required)

Insight Global is an international talent and consulting company that delivers business outcomes in an ever-changing world. We obsess over solving problems and building solutions that move our customers further, faster. With access to top talent in more than 50 countries, our tech-enabled recruiters can build teams quickly. Our technical experts across Cloud, AI, Data, Enterprise Operations, and Applied Engineering deliver solutions tailored to each customer’s needs. As those needs evolve, so do we. As we evolve, though, we stay true to our purpose: to develop people personally, professionally, and financially so they can be the light to the world around them. It shows up in everything we do, from investing in our people to delivering results for our customers to making a meaningful impact in our communities.

We're seeking a passionate and highly motivated Nurse Care Manager to join our dynamic Care and Case Management team. In this telephonic role, you'll play a crucial part in holistically guiding our members through their healthcare journey, ensuring their needs are met with industry-leading interventions. This position places a special emphasis on proactive engagement with high-risk and rising-risk members, particularly around discharge planning and care transitions. You will partner with a multidisciplinary clinical team that includes a variety of healthcare professionals, care coordinators, and records specialists, to deliver integrated remote care in an innovative way. The ideal candidate will enjoy spending time on the phone, actively listening to members’ needs, answering questions, and serving as a dedicated advocate. You should excel at creating cohesive care plans and possess the clinical acumen to guide members through complex situations, leveraging available benefits and resources. Schedule: Monday-Friday, 9:00 AM-6:00 PM local time zone

Engage in high-value Care Management outreach calls for Included Health members with the primary goal of clinically engaging high-risk and rising-risk members, fostering strong relationships and promoting proactive health management. Make proactive calls to members once their hospital discharge is confirmed, conducting thorough intake assessments if the member is reached. Collaborate with hospital-based case managers to understand & support members' specific discharge needs and actively encourage members to engage with our Care Management program. Perform initial assessments encompassing activities of daily living, cognitive functions, social determinants of health (SDOH), health beliefs and behaviors, and life planning activities to develop truly holistic care strategies. Deliver coordinated, patient-centered virtual Care Management by telephone and/or video that consistently improves members’ health outcomes. Generate impactful care plans collaboratively with members and our multidisciplinary care team, empowering members to achieve their desired health goals. Coordinate necessary resources that holistically address members’ problems, whether clinical or social.