Remote RN Case Manager
Location: Fully Remote (Michigan RN License Required)
Position Overview
We are seeking an experienced Registered Nurse Case Manager to coordinate comprehensive, member-centered care for a diverse health plan population. In this fully remote role, you will serve as the primary point of contact for members, caregivers, and providers while leading the development and execution of individualized care plans that improve health outcomes and ensure continuity of care.
Working alongside a multidisciplinary team, you will assess member needs, coordinate services, address barriers to care, and connect members with the resources needed to achieve their health goals.
Key Responsibilities
- Coordinate care with an interdisciplinary team including Social Workers, Dietitians, Pharmacists, Clinical Support Staff, and Medical Directors.
- Assess members’ medical, behavioral, psychosocial, and support needs.
- Develop, implement, monitor, and evaluate individualized care plans.
- Identify gaps in care and address barriers impacting member outcomes.
- Connect members with community resources, behavioral health services, financial assistance programs, and other support services.
- Collaborate with providers, caregivers, and community organizations to ensure continuity of care.
- Educate members on disease management, medication adherence, nutrition, and self-care strategies.
- Support discharge planning and transitions between healthcare settings.
- Arrange durable medical equipment (DME), transportation, and other necessary services.
- Document member interactions accurately and maintain compliance with established protocols and quality standards.
- Utilize phone, email, text messaging, and digital platforms to engage and support members.
Required Qualifications
- Current, active, and unrestricted Michigan Registered Nurse (RN) license.
- Nursing Diploma or Associate Degree in Nursing required.
- Minimum 3 years of clinical nursing experience in acute care, post-acute care, community health, or similar settings.
- Strong critical thinking, problem-solving, and care coordination skills.
- Excellent verbal and written communication skills.
- Ability to work independently while collaborating effectively with a team.
- Proficiency with Microsoft Office (Outlook, Teams, Excel, Word, OneNote) and electronic documentation systems.
Preferred Qualifications
- Bachelor’s Degree in Nursing (BSN).
- 1+ year of case management experience in a managed care or health plan environment.
- Experience providing care management through telephonic and digital communication channels.
- Certified Case Manager (CCM) certification.
- Certified Chronic Care Professional (CCP) certification.
- Experience with motivational interviewing techniques.
What We’re Looking For
- Compassionate and member-focused approach to care.
- Strong organizational and time management skills.
- Ability to manage multiple priorities and systems simultaneously.
- Comfortable building relationships with members, caregivers, providers, and community partners.
- Passion for improving health outcomes through proactive care management.
This is a fully remote opportunity with no onsite requirements. Candidates must maintain an active Michigan RN license.