Registered Nurse Case Manager

Job Summary

Providing telephonic case management for high-utilization patients, the fully remote Registered Nurse Case Manager will support members with complex or chronic conditions by developing individualized care plans, coordinating care across various healthcare services, and advocating for appropriate care while ensuring compliance with clinical guidelines.

Key responsibilities

• Identify members for case management and conduct comprehensive assessments of their medical, behavioral, and social needs
• Develop and coordinate individualized care plans, facilitating communication among patients, providers, and health plans
• Evaluate precertification requests and support medical decision-making while documenting all interventions and outcomes accurately

Required qualifications

• Active, unrestricted Registered Nurse (RN) license in good standing
• Associate's or Bachelor's degree in Nursing
• 5+ years of clinical nursing experience, including transplant nursing experience
• Strong knowledge of chronic disease management and experience managing complex patient populations
• Ability to work four 10-hour shifts per week and reside in Iowa, Arizona, or Idaho