NEW JOB OPENING
CARE MANAGER - REGISTERED NURSE (RN)
IN Remote, USA!

Required Education:

• Associate of Science in Nursing (ASN) degree



Preferred Education:

• Bachelor of Science in Nursing (BSN)



Required License/Certification:

• Active, unrestricted Compact Registered Nurse (RN) license in the candidate’s state of residence



Required Qualifications/Skills/Experience:

• 3+ years of nursing experience

• 2+ years of case management, discharge planning, and/or home healthcare coordination experience

• Proficiency in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams

• Ability to work independently and collaborate with teams virtually

• Access to a private, dedicated workspace suitable for remote work

• Ability to maintain focus and perform work without interruptions during scheduled working hours

• Strong verbal and written communication skills

• Ability to meet performance and productivity metrics, including call volume and successful member engagement

• Ability to meet applicable state and federal regulatory requirements

• Strong organizational, interpersonal, and customer service skills



Preferred Qualifications/Skills/Experience:

• Experience providing care management for Medicare and/or Medicaid members

• Experience working with individuals with social determinants of health (SDoH) needs, chronic medical conditions, and/or behavioral health conditions

• Experience conducting health-related assessments and facilitating individualized care planning

• Bilingual skills, especially English and Spanish



Care Manager – Registered Nurse (RN) Overview:

• The Care Manager – Registered Nurse is an integral member of the Special Needs Plan (SNP) care team, responsible for coordinating care for members with complex chronic medical conditions, behavioral health needs, and social determinants of health (SDoH) challenges

• The role involves conducting comprehensive assessments, identifying member needs, and connecting individuals with appropriate health plan benefits, community resources, and support services

• The Care Manager develops and implements individualized care plans, monitors member progress, provides evidence-based disease management education, and advocates for necessary services

• Working collaboratively with an interdisciplinary care team, the RN helps address barriers to care, support stable health outcomes, and ensure a coordinated healthcare experience

• Accurate and timely documentation of assessments, interventions, and care management activities in the member’s electronic health record is essential

• The position also requires meeting regulatory timelines, maintaining productivity standards, and participating in team meetings to discuss member status and care strategies

• Approximately 50–75% of the workday is dedicated to telephonic member engagement and care coordination. Candidates must be self-directed, comfortable using healthcare technology, and able to work independently in a fully remote environment while maintaining strong communication, documentation, and customer service standards



Job Duties:

• Dedicate approximately 50–75% of the workday to telephonic member engagement and care coordination

• Compile available clinical information and collaborate with members to develop individualized care plans, goals, and interventions

• Provide evidence-based disease management education and support to help members achieve health goals

• Ensure appropriate interdisciplinary care team members are involved in each member’s care

• Coordinate services to support a seamless healthcare experience for members

• Document care management activities accurately and promptly in the member’s electronic health record

• Collaborate with interdisciplinary care team members to address barriers to care and develop strategies to maintain members’ stable health conditions

• Identify and connect members with health plan benefits and community resources

• Meet regulatory requirements and applicable deadlines

• Support other care team members through clinical decision-making and guidance as needed

• Meet performance and productivity metrics, including call volume, successful member engagement, and state and federal regulatory requirements

• Maintain integrity, professionalism, self-direction, and positive working relationships with members and colleagues

• Learn and apply care management processes within Medicare and Medicaid managed care as needed

• Navigate healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records

• Participate in special projects and process improvement initiatives as assigned

• Assist with mentoring new team members as needed

• Participate in team meetings and support team objectives and high-quality member care

• **Only those lawfully authorized to work in the designated country associated with the position will be considered.**

• **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**