Case Manager RN

Telephonically assess, plan, implement, and coordinate case management activities for members enrolled in Federal Plans. Evaluate the medical needs of members to facilitate and promote overall wellness, developing proactive courses of action to enhance short- and long-term outcomes. Apply data-driven methods to identify members and build individualized case management programs or referrals to alternative healthcare programs.

Conduct comprehensive clinical assessments, evaluate needs, and develop flexible approaches based on member needs, benefit plans, and external programs. Advocate for patients within their existing health care coverage. Promote quality, cost-effective outcomes and suggest improvements to program/operational efficiency. Identify and escalate quality-of-care issues through established channels. Use motivational interviewing and assessment techniques to gauge health literacy, technology capability, and readiness to change, driving member engagement and behavior change.

100% remote with no travel. Schedule: Monday–Friday, 8-hour shift between 7am–5pm Arizona time. Must reside in PST, MST, or Arizona time zones. Requires active, unrestricted RN license in state of residence with ability to be licensed in all non-compact states. 3+ years clinical practice experience required; 1+ year of MS Office experience. Case management experience and CCM certification preferred. Associate's degree required, BSN preferred. Salary: $60,522–$129,615 plus bonus eligibility.