Float Pool (RN) Case Management Lead Analyst – Evernorth Health Services – Remote Full Time

Responsibilities:

• Obtain informed verbal and written consent.
• Identify and resolve customer healthcare needs.
• Build relationships with customers, clients, and providers.
• Set short- and long-term goals for case management.
• Promote quality, cost-effective outcomes.
• Implement, coordinate, and monitor case plans.
• Document case findings clearly and accurately.
• Act as liaison between parties involved in care.
• Build relationships with internal team members.
• Maintain accurate case records and data.
• Adhere to quality assurance and case management standards.
• Demonstrate sensitivity to diverse situations.
• Ensure privacy, confidentiality, and safety.
• Provide leadership and mentorship as needed.
• Comply with all regulatory and accreditation standards.
• Participate in corporate training and continuing education.
• Manage a high volume of outbound calls and work.
• Address customer concerns and assign complex cases.
• Use resources effectively for customer support.
• Manage case outcomes and apply savings in real-time.
• Meet/exceed performance metrics and quality standards.
• Ensure timely follow-up per URAC guidelines.

Requirements:

• Active unrestricted Registered Nurse (RN) license.
• High-performing case manager experience.
• Strong time management and organizational skills.
• Proficiency with computer and case management systems.
• Access to high-speed internet and private workspace.
• Experience in PDN and case management certification preferred.
• Proficient in Microsoft Office and internet research.
• Skilled in telephonic and digital communication.
• Ability to manage multiple cases and resolve conflicts.
• Demonstrates cultural sensitivity and flexibility.
• Ability to adapt in fast-paced environments.
• Must meet PMD and quality score metrics.

Benefits:

• Medical, vision, and dental benefits.
• 401(k) with company match.
• Paid life insurance.
• Tuition reimbursement.
• Minimum of 18 days paid time off per year.
• Paid holidays.
• Annual bonus plan eligibility.
• Employee well-being and behavioral health programs.
• Company-paid life insurance.