Case Manager - Registered Nurse - Southeast Region
$60,522–$129,615 year
RemoteUnited States
Job Summary
Coordinate catastrophic and chronic illness cases across the continuum of care, including consultant referrals, home care visits, and community resource utilization. Act as a liaison with members, families, providers, and insurance carriers to assess medical status, develop care plans, and determine benefit eligibility. Conduct telephonic and in-person interactions to facilitate condition management, optimize wellness outcomes, and support timely return to work or baseline function. Prepare required documentation, consult with internal multidisciplinary teams, and monitor progress toward desired goals while applying relevant laws and carrier-specific instructions. Requires active Compact RN licensure in the Southeast Region with 3+ years clinical experience and 2+ years in case management or discharge planning.
Required Qualifications
- Candidates must live in the Southeast Region (States Include- FL, GA, AL, MS, NC, SC, TN, AR, LA)
- Candidate must have active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence
- 3+ years clinical practical experience with preference in the following areas: diabetes, Congestive Heart Failure (CHF), Chronic Kidney Disease (CKD), post-acute care, hospice, palliative care, cardiac, home health with Medicare members
- 2+ years case management, discharge planning and/or home health care coordination experience
- 2+ years of experience with Microsoft Word, Excel, and Outlook
- Associate's Degree in Nursing or Nursing Diploma (REQUIRED)
Desired Qualifications
- Previous work from home experience in a healthcare related field
- Excellent analytical and problem-solving skills
- Effective communications, organizational, and interpersonal skills
- Ability to work independently
- Certified Case Manager National professional certification (CRC, CDMS, CRRN, COHN, or CCM)
- Efficient and effective computer skills including navigating multiple systems and keyboarding
- Bachelor's Degree in Nursing (PREFERRED)
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