Nurse Case Manager

We're building a world of health around every individual , shaping a more connected, convenient, and compassionate health experience.

The Nurse Case Manager is responsible for delivering comprehensive case management services through telephonic and/or face-to-face interactions.

What you will do

• Utilize clinical judgment and data-driven tools to evaluate member eligibility, identify health risks, and develop proactive care plans that address both short- and long-term health outcomes.
• Conduct holistic assessments that consider co-morbid conditions, functional limitations, and social determinants of health.
• Review prior claims, evaluate work capacity, and determine the need for referrals to clinical resources.
• Collaborate with supervisors and multidisciplinary teams to overcome barriers and optimize care planning.

Required Qualifications

• An active and unrestricted RN license in the state of residence.
• Willing and able to obtain additional state licenses upon hire (paid for by the company).
• 3+ years' experience in acute care and/or case management.
• 2+ years' Med/Surg experience.
• Must be willing to work Monday-Friday 8:00am-4:30pm local time zone.

Preferred Qualifications

• Prefer candidate in PST Zone.
• Behavioral Health experience.
• Certified Case Manager.
• Managed care experience.
• Strong telephonic communication skills.
• Ability to manage multiple priorities, effective organisational, and time management skills.
• Ability to use a computer station and sit for extended periods of time.

Benefits This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00