Medical Management Manager jobs in Sioux Falls, SD

Award Winning Health Care:  Avera has been named among the nation’s 15 Top Health Systems, Forbes list of America’s Best-in-State Employers and Level 10 Most Wired Health Care Organization by CHIME.

Culture:  Be part of a multidisciplinary team built on teamwork, with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

You Belong at Avera:  Competitive pay, front-loaded PTO and options for free health insurance, sign-on bonuses, various shifts to fit your lifestyle and opportunities for career growth.

Avera is looking for a Registered Nurse (RN) - Case Manager to join our Team!

Position Highlights:

• Paid Time Off (PTO) available on Day 1!
• Options for Free Health Insurance!
• This position has the opportunity to work remotely!
• Positive Work Environment: Be part of an organization where we practice the mission in our daily operations and demonstrate our pride by delivering excellent care.

Job Summary

• The RN Case Manager is a specialized nurse that identifies members who would benefit from complex/chronic condition case management and/or service coordination.
• The RN Case Manager develops and facilitates the member’s plan of care. In collaboration with physicians, population health staff, employers, community organizations, hospital-based case managers/utilization review staff, clinic-based care coordinators/preauthorization staff, and Insurance Division staff, the RN Case Manager encourages the best possible outcome in the most cost effective manner in accordance with standards set forth by National Committee for Quality Assurance (NCQA). 
• The RN Case Manager will need to be knowledgeable in various aspects of all health plan lines of business, inclusive of commercial, marketplace, and self-funded clients.
• The position requires interaction with health system stakeholders, key opinion leaders, vendors, delegated entities, healthcare providers, policy makers, and accreditation and government organizations.

Education and/or Experience

• Graduate from an accredited RN program (Associate’s degree or Bachelor of Science degree).
• Four years of professional nursing practice experience preferably in the acute care setting.
• Case-management, disease-management, care coordination or equivalence preferred.
• Proficient in Microsoft Word, Excel, Access and Power Point.  Familiarity with data extraction tool is desirable.

Licensure/Certification/Registration

• Licensed as a Registered Nurse in the state of South Dakota and/or meeting the requirements of the enhanced Nursing Compact Licensure (eNCL) required.
• Registered Nurse in the state of Minnesota or within 120 days of employment required.
• Certification in Case Management, Managed Care Nursing or a related specialty to be completed within 2 years of hire date.

Work Schedule

• Monday - Friday; 80 hours every 2 weeks
  • 8:00 am - 5:00 pm

Pay

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

• $29.50- $44.25 per hour

What Makes Avera Special?