Case Manager RN

The Case Manager RN uses a collaborative process of assessment, planning, facilitation, and advocacy to meet members' benefit plan and health needs, promoting cost-effective outcomes. Responsibilities include assessing member health status and care coordination needs, inpatient review, discharge planning, and developing/implementing/monitoring case management plans, escalating to the Medical Director as needed.

Day-to-day involves applying data-driven methods to identify members for individualized case management programs, conducting comprehensive clinical assessments, advocating for patients within their coverage, and identifying quality of care issues. The nurse uses motivational interviewing to engage members, assesses health literacy and readiness to change, and provides coaching, education, and support to empower informed health decisions.

Working hours are Monday–Friday, 8:00am–4:30pm in the nurse's time zone, with a 10:30am–7:00pm rotation several times per quarter and rotational evening/weekend/holiday coverage as needed. No travel expected.

Requires an active unrestricted RN license in state of residence with willingness to obtain multi-state licensure (company-paid), 3+ years acute care RN experience, and 3+ years Microsoft Office experience. ADN required, BSN preferred. Compact RN, CCM, managed care, telephonic case management, and 2+ years oncology experience preferred. Salary range $54,095–$155,538 plus bonus eligibility.