Case Manager Nurse-RN [Remote]

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Case Manager Nurse-RN in United States.

This role is focused on delivering high-impact, telephonic case management to support patients across the full continuum of care. You will work closely with members, families, providers, and care teams to ensure high-quality, cost-effective healthcare outcomes. The position blends clinical expertise with coordination and advocacy, helping patients navigate complex medical, psychosocial, and financial needs. You will assess patient conditions holistically and build individualized care plans that drive measurable improvements in health and cost efficiency. Operating in a remote and flexible environment, you will collaborate with multidisciplinary teams while maintaining autonomy in case decision-making. This is an excellent opportunity for an experienced RN who enjoys meaningful patient interaction and outcome-driven care management.

Accountabilities:

• Conduct comprehensive telephonic patient assessments covering physical, psychosocial, emotional, environmental, spiritual, and financial needs, ensuring a complete clinical understanding of each case.
• Develop, implement, and monitor individualized treatment and care plans in collaboration with patients, families, providers, and care teams, ensuring measurable and cost-effective outcomes.
• Review claims and clinical data to identify appropriate care programs, evaluate risk, and support utilization review and case stratification.
• Track progress, evaluate intervention effectiveness, and report outcomes through structured case documentation and periodic updates for high- and low-risk cases.
• Coordinate care across multidisciplinary teams, advocate for patients, and facilitate access to community resources and wellness programs.
• Ensure accurate documentation, compliance with HIPAA standards, and timely reporting within case management systems while meeting productivity and quality standards.
• Support care optimization efforts by mentoring junior clinical staff and contributing to cost containment and care improvement initiatives.

Requirements:

• Active Registered Nurse (RN) license (California license required; multi-state license preferred) and graduation from an accredited nursing program.
• Minimum of 5 years of clinical experience in medical-surgical, acute care, emergency, or critical care settings, including at least 2 years in case management.
• Strong understanding of claims data, ICD-10, CPT, and HCPCS coding, with the ability to interpret clinical and utilization information effectively.
• Experience developing care plans, discharge planning, and coordinating across healthcare systems and community resources.
• Proficiency with Microsoft Office Suite and healthcare systems for documentation and case tracking.
• Strong communication, negotiation, and interpersonal skills with the ability to work independently and manage complex caseloads.
• Highly organized, detail-oriented, and able to prioritize tasks while meeting productivity and turnaround requirements.

Benefits:

• Competitive hourly compensation ranging from $36 to $38 per hour, based on experience and location.
• Flexible part-time schedule designed to support work-life balance and personal priorities.
• Access to learning, development, and mentorship opportunities to support career growth in clinical case management.
• Technology and tools provided to support remote work and daily case management responsibilities.
• Exposure to multidisciplinary healthcare environments and opportunities to develop advanced care coordination expertise.

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.