South Carolina Licensed RN Care Manager

Job Summary

Providing high-touch case management services, the full-time Remote RN Concierge Care Manager (Maternity/NICU) will coordinate care for high-risk patients, implement individualized care plans, and collaborate with external providers to enhance healthcare outcomes for members across South Carolina and nationally.

Key responsibilities

• Direct day-to-day management of high-risk patient populations, including coordination of treatment plans and benefit coordination
• Facilitate clinical services collaboration with external providers, vendors, and community services
• Participate in team training, continuing education, and prepare for external audits and quality assurance efforts

Required qualifications

• Associate's degree in nursing or graduate of an accredited school of nursing, or master's degree in social work, psychology, or counseling
• 5 years of case management experience or 2 years in a health insurance environment
• Active, unrestricted RN licensure in the state of hire or compact multistate RN license
• Nationally recognized Case Management certification to be obtained within 2 years of hire
• Working knowledge of Microsoft Office and quality improvement processes