Registered Nurse Case Manager

Job Summary

Managing an individual caseload, the full-time Registered Nurse Case Manager will oversee service authorizations, review treatment plans for medical necessity, and maintain ongoing communication with healthcare team members in a remote setting.

Key responsibilities:

• Review medical data to establish and update Case Management plans, ensuring accountability and effective communication with providers and patients
• Assess patient needs, set goals, and document actions in case notes while determining the appropriate interventions
• Engage with payer offices to understand benefit constraints impacting the case management plan and participate in quality management initiatives

Required qualifications:

• Current active and unrestricted Registered Nurse licensure in the United States or its territories
• Bachelor's degree in a health-related field preferred
• Seven years of varied clinical experience preferred
• Proficiency in MS Office Suite products (Word, Excel, PowerPoint)
• Ability to independently manage a full caseload while adhering to URAC standards