Registered Nurse Case Manager

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