Registered Nurse Case Manager

Job Summary

Managing an individual caseload remotely, the full-time Registered Nurse Case Manager will oversee the case management process, including service authorization, treatment plan reviews, and ongoing communication with healthcare team members.

Key responsibilities

• Review medical data to establish and maintain accountability for case management plans, incorporating collaboration with providers, payers, and patients
• Assess patient needs, set goals, and document actions to achieve those goals, while maintaining regular contact across the continuum of care
• Negotiate with providers to maximize medical benefits and maintain comprehensive case documentation in the computer system

Required qualifications

• Current active and unrestricted Registered Nurse license in the United States or its territories
• Bachelor's degree in a health-related field preferred
• At least 7 years of varied clinical experience preferred
• URAC-recognized certification in Case Management required within 3 years of hire
• Familiarity with community resources and funding sources for patient support