Case Manager, Registered Nurse
Posted 2026-05-05
Remote, USA
Full-time
Immediate Start
- Job Description:
- Delivering comprehensive case management services through telephonic and/or face-to-face interactions
- Assessing, planning, implementing, and coordinating care strategies to support members' medical needs and promote overall wellness
- Utilizing clinical judgment and data-driven tools to evaluate member eligibility, identify health risks, and develop proactive care plans
- Conducting holistic assessments that consider co-morbid conditions, functional limitations, and social determinants of health
- Reviewing prior claims, evaluating work capacity, and determining the need for referrals to clinical resources
- Collaborating with supervisors and multidisciplinary teams to overcome barriers and optimize care planning
- Operating within established regulatory and organizational policies, applying case management processes and service strategies
- Requirements:
- An active and unrestricted RN license in the state of residence
- Willing and able to obtain additional state licenses upon hire (Paid for by the company)
- 3+ years' experience of acute care and/or case management
- 2+ years' Med/Surg experience
- Must be willing to work Mon-Fri 8-430 PST time zone
- Behavioral Health experience preferred
- Certified Case Manager preferred
- Managed care experience preferred
- Strong telephonic communication skills
- Ability to manage multiple priorities, effective organizational, and time management skills
- Ability to use a computer station and sit for extended periods of time
- Benefits:
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility