Case Manager – RN
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Remote RN Case Manager managing caseloads, medical necessity reviews, and treatment plans for MedWatch’s population health management services. Coordinating patients, providers, payers, and caregivers while maintaining URAC quality standards.
Responsibilities:
- Manage an individual caseload using the Case Management process for MedWatch customers and consumers
- Authorize services and review treatment plans for medical necessity and standards of care
- Maintain ongoing communication with members of the healthcare team
- Review medical data to establish, update, and maintain accountability for Case Management plans
- Contact providers, payers, patients, and primary caregivers
- Assess problems and determine patient goals and actions
- Document assessments, goals, interventions, and progress in case notes
- Contact payer offices to understand benefit constraints affecting the plan of action
- Adhere to company policies and procedures
- Participate in the Quality Management Program and identify service improvement opportunities
- Independently manage a full caseload and complex MNRs while maintaining URAC standards
Requirements:
- Current, active, and unrestricted Registered Nurse license in the state of current practice and residence within the United States or its territories
- Bachelor's degree in a health-related field preferred
- 7 years of varied clinical experience preferred
- Good organizational and time management skills
- Excellent verbal and written communication skills
- Ability to handle difficult situations tactfully and diplomatically
- Effective problem-solving and decision-making skills
- Strong computer skills
- Proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint
- Ability to independently manage a full caseload while maintaining URAC standards
- Ability to manage complex MNRs accurately
- Consistently score 90% or greater on monthly audits
- Ability to work in the United States without employer sponsorship
- Dedicated, quiet workspace in a home office
Benefits:
- Paid time off
- Medical insurance
- Dental insurance
- Vision insurance
- Short-term disability
- Long-term disability
- Life insurance
- AD&D insurance
- 401(k) with match
- Critical illness coverage
- Legal plan
- Identity theft coverage
- Pet insurance
- Discount programs
- Competitive compensation
- Comprehensive benefits package
Similar Jobs
Development Manager, Strategic Philanthropy
Development Manager advancing philanthropic pipelines and donor relationships for a global nonprofit. Supporting prospect research, CRM oversight, fundraising strategy, and high-touch donor events.
Case Manager Assistant, LPN
Case Manager Assistant supporting RN-led case management for MedWatch, a population health management company. Coordinating healthcare services, reviewing medical necessity, documenting cases, and connecting patients with resources.
Case Manager, RN – Licensed in all 50 states
Registered Nurse Case Manager managing patient caseloads for MedWatch’s population health management services. Coordinating medically necessary care, benefits, providers, and payer communications remotely.
Manager, Carrier Download
Manager leading enterprise carrier download strategy for Patriot, a national insurance services firm. Improving insurance policy, billing, and claims data quality, automation, and adoption.
Licensing Programs Manager
Licensing Programs Manager advancing Scouting America’s youth-focused brand licensing programs. Managing 100+ partners, licensed products, retail expansion, negotiations, and brand compliance.
Product Line Manager – Precast
Product Line Manager growing MAPEI’s precast and prestressed concrete business. Developing national strategy, customer relationships, product positioning, and sales-support initiatives.
Real Estate Manager – Central Region
Real Estate Manager advancing Bagel Brands’ new-store development pipeline across Texas and the Central region. Evaluating sites, negotiating LOIs, and coordinating real estate, design, construction, operations, and finance teams.
Performance Manager
vAuto Performance Manager retaining dealership clients and expanding software adoption for Cox Automotive. Managing regional accounts, launches, at-risk customers, and product upsells across automotive retail markets.
Assistant Manager
Assistant Manager supervising remote U.S. customs brokerage operations for A.N. Deringer. Leading teams, managing workflow, supporting clients, and ensuring regulatory compliance.
Global Data Centers and Hydrogen Commercialization Manager
GE Vernova commercialization manager developing aeroderivative power opportunities for data centers and hydrogen. Partnering with sales, engineering, and customers to convert projects into orders.
Change Order Manager
Change Order Manager at Precision for Medicine, a clinical-trial services company. Developing budgets, variance analyses, and client-facing contract change orders.
Change Order Manager
Change Order Manager preparing clinical-trial budgets and contract documents for Precision Medicine Group. Analyzing financial impacts and coordinating change orders with project teams and clients.
Manager, Operational Resilience – Technology Currency
BMO manager leading resilience, disaster recovery, and technology currency initiatives for critical U.S. banking services. Managing a team and coordinating enterprise remediation across technology, infrastructure, business, and risk stakeholders.
Engagement Manager
Engagement Manager delivering data, AI, and digital transformation programmes for Colibri Digital. Managing clients, commercial controls, complex delivery teams, and enterprise AI/ML engagements.
Senior Manager, Medicaid Product
CVS Health Medicaid product leader managing Salesforce-based benefits platforms. Driving product development, analytics, vendor performance, and health-plan initiatives.
Environmental Remediation Area Manager
AECOM Area Manager leading environmental site assessment and remediation programs in California. Overseeing project delivery, staff, client relationships, operations, and business development for infrastructure consulting clients.
Environmental Remediation Area Manager
Environmental Remediation Area Manager overseeing AECOM environmental assessment and remediation programs in California. Driving client delivery, staff development, business growth, and operational performance.
Portfolio Manager, English Language Learning
Portfolio Manager defining strategy for English language learning products at Cengage, a global education technology company. Researching markets, shaping proposals, and leading portfolio growth initiatives.
Manager, Commercial & Civil Launch Services
Business development manager advancing commercial and U.S. civil launch opportunities for Firefly Aerospace’s Alpha rocket. Coordinating customer discovery, technical scoping, capture materials, proposals, and leadership recommendations.
Regional Property Manager
Regional Property Manager overseeing affordable apartment communities for ALCO Management. Leading teams, budgets, compliance, maintenance, and portfolio performance across the Southeast.