Case Manager - NLC

Case Manager - NLC

This remote Case Manager role offers the opportunity to make a meaningful difference in patients' health outcomes through comprehensive, patient-centered care coordination. You will assess medical, psychosocial, and long-term needs while developing individualized plans designed to support optimal recovery. The role combines clinical expertise, advocacy, care coordination, and collaboration with providers, payors, and community resources. You will identify barriers to effective care and help patients access appropriate services, resources, and alternative levels of care. Success requires strong clinical judgment, organization, communication, and the ability to independently manage complex cases. You will work closely with interdisciplinary teams while ensuring quality, cost effectiveness, regulatory compliance, and continuity of care. This is an opportunity for an experienced RN to expand their impact beyond direct clinical care within a collaborative healthcare environment.

Accountabilities

• Apply the core principles of case management, including assessment, planning, implementation, coordination, monitoring, and evaluation, to support patients throughout their care journey.
• Conduct comprehensive assessments of patients' medical, social, psychological, and long-term needs using relevant health and social histories.
• Develop individualized plans of care based on clinical assessments, patient needs, provider recommendations, benefit-plan considerations, and cost-effectiveness factors.
• Continuously monitor and evaluate care plans, adjusting interventions as patient needs, clinical circumstances, or available resources change.
• Identify barriers that may prevent successful care outcomes and implement appropriate solutions, alternative services, or levels of care.
• Advocate for patients by identifying potential complications, understanding the physical and psychosocial impact of illness, and helping patients access appropriate services and resources.
• Establish and maintain effective working relationships with physicians, providers, payors, support staff, and other members of interdisciplinary care teams.
• Coordinate decisions, documentation, reimbursement, appeals, and other case-management processes while maintaining accurate and timely records.
• Evaluate the quality and cost effectiveness of services in collaboration with payors, providers, and other stakeholders, including negotiating cost discounts when appropriate.
• Identify and coordinate alternative care options such as rehabilitation facilities, home health services, community programs, assistive equipment, and other appropriate resources.
• Research and develop community support networks that can help patients achieve improved psychological, social, and physical outcomes.
• Clearly communicate available services, benefits, and resources to patients and assist them in accessing appropriate support.
• Apply relevant case-management principles, confidentiality requirements, liability considerations, disability legislation, and scope-of-practice standards.
• Analyze case outcomes, apply structured problem-solving techniques, and implement alternative approaches when appropriate.
• Maintain timely documentation of patient care plans and ensure compliance with applicable regulatory and privacy requirements.
• Participate in professional development, continuing education, training initiatives, and relevant organizational committees.
• Provide guidance and support to support staff as appropriate and contribute to orientation and training related to the Case Manager role.
• Perform all assignments professionally and independently while demonstrating accountability, collaboration, trust, and passion for patient care.

Requirements

• Active, current, unrestricted Registered Nurse (RN) license in a Nurse Licensure Compact (NLC) state.
• Bachelor's degree in nursing or a related field is preferred.
• Case Management Certification (CCM) is required; candidates without the certification must obtain it within three years of employment.
• At least three years of clinical RN experience in a medical/surgical or ambulatory care setting.
• Clinical experience in behavioral health, transplant, neonatal care, oncology, or another relevant specialty is preferred.
• Previous managed-care experience is an advantage.
• Strong clinical knowledge of the healthcare and social-support needs of the populations served.
• Demonstrated ability to identify barriers to successful care management and develop practical solutions.
• Strong understanding of care coordination, alternative care models, community resources, and interdisciplinary collaboration.
• Excellent problem-solving, organization, prioritization, and time-management skills.
• Strong written, verbal, and interpersonal communication skills, with the ability to work effectively with patients, physicians, providers, payors, and other stakeholders.
• Ability to work independently while exercising sound clinical judgment and maintaining accurate, timely documentation.
• Flexibility to manage changing assignments, schedules, patient needs, and priorities.
• Knowledge of assistive and adaptive equipment and applicable disability-related legislation, including the Americans with Disabilities Act.
• Ability to practice appropriately within the scope of a multi-state RN license.
• Demonstrated commitment to professional conduct, confidentiality, quality improvement, and patient advocacy.
• Ability to work in alignment with core values centered on passion, teamwork, accountability, and trust.
• Employment visa or immigration sponsorship is not available for this position.

Benefits

• $35.50$38.00 per hour hiring compensation range.
• Compensation may vary based on skills, education, location, experience, and other job-related factors.
• Potential eligibility for a scorecard-based incentive.
• Comprehensive employee benefits package.
• Medical and healthcare benefits.
• Retirement benefits.
• Generous paid time off.
• Paid holidays.
• Remote work environment.
• Opportunities for professional development and continuing education.
• Supportive, collaborative culture focused on growth, innovation, and teamwork.
• Opportunities to make a meaningful impact through patient advocacy and care coordination.
• Equal opportunity workplace with reasonable accommodations available for qualified applicants.