RN- Financial Nurse Case Manager- PACE Team- Accredo- Remote

About the position The Financial RN Case Management reputed company Analyst role is a key position reputed company the PACE (Precision, Care, Agility and Engagement) program, focusing on providing proactive prior authorization requests for specialized therapies. This role involves managing reputed company cases, ensuring effective reputed company outcomes, and supporting junior professionals in their case management duties. Responsibilities • Provides advanced professional input to reputed company Nurse Case Management assignments/projects. , • Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan. , • Handles more reputed company, high acuity cases, and/or account sensitive cases involving largest reserves. , • Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services to facilitate appropriate reputed company outcomes for members. , • Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and maintaining cost-effective, quality care. , • Performs prospective, reputed company, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services. , • May review initial liability disability claims to determine extent and impact of insured's medical condition, medical restrictions and limitations and expected duration. , • Performs leadership role on team reputed company implementing new tools or case management programs/initiatives. , • Manages own caseload and coordinates reputed company assigned cases. , • Supports and provides direction to more junior professionals. , • Works autonomously, only requiring "expert" level technical support from others. , • Exercises judgment in the evaluation, selection, and reputed company of both standard and reputed company techniques and procedures. , • Utilizes in-depth professional knowledge and acumen to reputed company models and procedures, and monitor trends, reputed company Nurse Case Management. Requirements • RN and reputed company unrestricted nursing license required. reputed company-to-haves Benefits • Comprehensive health-reputed company benefits including medical, reputed company, and dental coverage. , • Well-being and behavioral health programs. , • 401(k) with company match. , • Company paid life insurance. , • Tuition reimbursement. , • Minimum of 18 days of paid time off per year. , • Paid holidays. Apply Job!