Case Manager Nurse- RN

Jobgether

4d • $36 - $38 • Hybrid

About The Position

This role offers the opportunity to provide telephonic case management for patients, caregivers, and healthcare providers, ensuring cost-effective, high-quality healthcare delivery. The Case Manager Nurse will assess patient needs, develop individualized care plans, and coordinate interventions across a multidisciplinary team. You will monitor outcomes, provide emotional support, and advocate for patients while managing documentation and compliance with relevant regulations. This position requires strong clinical judgment, communication skills, and the ability to balance multiple priorities in a remote or hybrid environment. It is ideal for experienced nurses who enjoy problem-solving, patient advocacy, and improving healthcare outcomes at scale. The role also includes mentoring junior staff and contributing to the efficiency and effectiveness of the care management process.

Requirements

• Graduation from an accredited Registered Nursing (RN) program and possession of a current RN license (multi-state license may be required).
• Minimum of 5 years medical/surgical or acute care experience, with at least 2 years in case management.
• Prior experience in emergency room, critical care, or relevant clinical care settings preferred.
• Knowledge of medical claims, ICD-10, CPT, HCPCS coding, and community resources.
• Ability to critically evaluate clinical data, develop treatment plans, and perform discharge planning.
• Strong communication, interpersonal, negotiation, and organizational skills.
• Proficiency with Microsoft Office Suite and comfort with electronic documentation systems.
• Ability to work independently, manage multiple priorities, and navigate a fast-paced environment.

Nice To Haves

• Prior experience in emergency room, critical care, or relevant clinical care settings preferred.

Responsibilities

• Conduct comprehensive patient assessments covering physical, psychosocial, emotional, and environmental needs.
• Develop, implement, and monitor individualized treatment plans in collaboration with patients, caregivers, and multidisciplinary teams.
• Review claims and clinical data to inform treatment plans and identify appropriate program participation.
• Initiate and maintain ongoing contact with patients, families, providers, and employers to ensure continuity of care.
• Advocate for patients to optimize care quality, reduce costs, and provide guidance and emotional support.
• Perform utilization reviews and document case activities thoroughly in compliance with HIPAA and company policies.
• Mentor LVNs and provide guidance on complex clinical cases and best practices.
• Track outcomes, report on intervention effectiveness, and support cost management initiatives.

Benefits

• Competitive hourly rate: $36–$38, depending on experience and location.
• Full benefits package starting on day one, including medical, dental, and mental health support.
• Paid Time Off (PTO) for rest and recharge.
• Retirement planning and financial protection programs.
• Professional development opportunities with learning budgets and career progression.
• Mission-driven, inclusive culture where diverse perspectives impact healthcare outcomes.
• Wellness programs and other employee perks to support overall wellbeing.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed