RN Case Manager

Accountabilities:: Assess, plan, implement, coordinate, monitor, and evaluate individualized care plans to address patients' health needs and promote positive clinical outcomes. Identify appropriate candidates for case management through referrals from multiple sources, explain available services, obtain voluntary participation, and maintain an appropriate patient caseload. Coordinate healthcare services by connecting patients with relevant plan benefits, community resources, and appropriate levels of care while supporting cost-effective healthcare delivery. Act as a liaison between patients, families, caregivers, physicians, hospital discharge planners, home healthcare providers, and other healthcare professionals to ensure continuity and accessibility of care. Provide specialized education and guidance on disease-specific conditions and support patients in understanding their healthcare needs and available treatment options. Apply evidence-based nursing practices and professional judgment to promote patient safety and ensure compliance with applicable regulations, state nursing requirements, organizational policies, and URAC standards. Stay informed about developments in medical and surgical procedures, healthcare services, medications, products, and broader healthcare delivery trends. Maintain accurate, confidential, and secure patient information while adhering to established information security and operational procedures. Perform additional responsibilities as required. Requirements: Active Registered Nurse (RN) license in good standing in the state or states where professional duties are performed. Bachelor's degree in Nursing (BSN) preferred. Minimum of four years of clinical experience in at least one of the following areas: case management, home health, critical care, medical/surgical nursing, discharge planning, concurrent review, or obstetric/neonatal care. Case management certification required. Candidates who do not hold certification upon hire must obtain a URAC-recognized certification within three years of starting the role. Accepted certifications include Certified Case Manager (CCM), Accredited Case Manager (ACM), and Registered Nurse–Board Certified (RN-BC). Strong clinical assessment, critical thinking, deductive reasoning, and problem-solving skills, with the ability to make sound, evidence-based decisions. Excellent interpersonal, collaborative, and communication skills, including the ability to work effectively with patients, families, and multidisciplinary healthcare teams. Ability to work independently, manage priorities, maintain attention to detail, and coordinate multiple patient needs efficiently. Proficiency in Microsoft Office applications, particularly Excel, Outlook, and PowerPoint, as well as familiarity with healthcare information systems and case management tools. Strong organizational, research, customer service, and written and verbal communication skills. Ability to maintain confidentiality and comply with applicable healthcare regulations and information security requirements. Must reside and work remotely within one of the following eligible states: Arkansas, Washington, Oregon, Utah, Idaho, North Dakota, or Minnesota. Preference may be given to current employees and candidates residing in Arkansas, Utah, Idaho, and North Dakota. Benefits: Competitive annual salary: Hiring range of $73,045 to $92,722.50, depending on qualifications and experience. Remote work flexibility: Full-time, work-from-home opportunity within the eligible U.S. states. Professional development: Tuition reimbursement to support continued education and career growth. Health and wellness initiatives: Access to wellness education and exercise incentives designed to encourage a healthy lifestyle. Employee wellness resources: Access to fitness facilities and healthy dining options at designated company locations. Inclusive workplace culture: A collaborative and supportive environment that values diversity, employee engagement, and long-term professional relationships. Community involvement: Opportunities to participate in charitable initiatives, volunteer activities, and community support programs. Full-time employment: Regular employment offering the opportunity to contribute to meaningful, patient-focused healthcare services.