Case Manager, RN

Do you envision working for a company that has the expertise of a long-standing industry leader, but the spirit of an entrepreneur? Does the thought of making a real impact motivate and energize you? If so, then Health Plans, Inc. is the place for you. Join a team that values integrity, flexibility, loyalty, compassion and dedication—we can’t wait to meet you.

What we do

HPI is unique. A respected industry leader that’s been serving customers for over 40 years, we’re known for our innovation and growth. Our experience has given us our expertise, but our forward-thinking, entrepreneurial spirit has given us our strong reputation. As a third-party administrator, we offer a suite of health and benefit solutions to employers. By joining HPI, you’ll contribute to ideas that make a real difference for employers and employees nationwide. There isn’t a challenge we won’t accept and we’re looking for people who have a passion to take it on. Not just a job—a mission.

What you’ll do

We’re looking for a dedicated, compassionate nurse to join the AchieveHealth® Care Management Services team as a case manager. In this role, you’ll have the opportunity to make a positive impact on the healthcare of individual members and promote positive outcomes by coordinating services and resources.

In this role, you’ll also:

• Conduct utilization management using standardized clinical criteria
• Consult with Physician Reviewers and other experts to determine appropriateness of care
• Develop individualized case management plans and Identify quality of care issues
• Telephonically assess members to ensure safe transition to next level of care upon discharge
• Determine and document quantifiable outcomes, including avoidable and actual dollar savings
• Continually educate the patient/family to promote self-management and self-advocacy
• Research available community resources and alternative funding sources as appropriate

What you bring:

• An active professional licensure as a Registered Nurse (RN) in MA, ME or NH
• 3+ years of clinical experience
• Competency in Windows-based computers

Bonus points if you:

• 3+ years Discharge Planning and/or Case Management experience
• Familiarity with URAC standards, Department of Labor, state/federal regulations

Why choose us?

• Our space is a reflection of who we are—innovative, open and collaborative.
• Love to get creative? We do too. Brainstorm in one of our team break-out rooms.
• We think feeling your best is an important factor in producing great work, so we embrace a “smart casual” dress code and work at ergonomic desks.
• Need to reenergize? Take a break to chat in the onsite café, go for a walk on one of the beautiful trails in our office park, or get in a quick workout at one of the campus gyms.
• We offer our employees flexible work arrangements including remote and hybrid options (depending on the position)
• We’re a people-first company and value giving back to our community. Ask us about our RISE Committee & and volunteer opportunities.

Benefits

We care about you and believe the greatest gift you can give yourself, your family, and the world is a healthy you! We offer a comprehensive and competitive benefits package to help you lead a happy, healthy life. Check out some of the benefits we offer to our employees:

• Medical, Dental and Vision Coverage
• Prescription Drug Coverage
• Fitness Reimbursement Benefit
• Tobacco Cessation Program
• Employee Assistance Program
• Flexible Spending Account & Health Savings Account
• 401(k) and Profit-Sharing Plan
• Quarterly Bonuses
• Generous Paid-Time Off
• Volunteer Days
• Education Assistance & Professional Development Opportunities
• ….and much much more!

So, think you want to join the HPI team? We hope to hear from you!

You can read more about us at hpitpa.com/about-us/careers/

EEO/AA/M/F/Vet/Disability Employer