Case Manager RN
Location
Fully Remote (Preference for candidates located in Michigan)
Schedule
Remote – No onsite work required
Type
Full-Time Contract
Pay Range
$37–$39 per hour
Summary
Join the team as a Case Manager RN and lead the coordination of holistic, person?centered care management for a diverse health plan population. In this role, you will serve as the primary point of contact for members, caregivers, and providers through phone, email, text, and digital messaging. You will apply the full case?management process—assessment, planning, implementation, monitoring, and evaluation—to optimize health outcomes across the care continuum. This position partners closely with clinical providers, community resources, and internal multidisciplinary teams to ensure members receive comprehensive, coordinated support.
Key Responsibilities
- Lead the coordination of a regionally aligned multidisciplinary team—including Medical & Behavioral Health Social Workers, Registered Dietitians, Pharmacists, Clinical Support Staff, and Medical Directors—to support member needs telephonically and digitally.
- Utilize the case?management process to assess, develop, implement, monitor, and evaluate individualized care plans.
- Conduct comprehensive assessments of members’ medical conditions, psychosocial needs, cultural preferences, and support systems.
- Engage members and caregivers to identify care barriers, close gaps, and drive improved health outcomes through individualized plans of care.
- Arrange necessary services such as community resources, mental health support, substance?abuse programs, financial assistance, and disease?specific care.
- Coordinate communication and care delivery between providers, community?based agencies, and family support systems.
- Advocate for members while promoting ongoing self?management and self?advocacy.
- Provide education on health literacy, medication management, self?care strategies, and nutrition.
- Monitor member progress, evaluate adherence to care plans, and adjust strategies based on goals and needs.
- Accurately document all interactions in alignment with quality, regulatory, and productivity standards.
- Support transitions of care by preparing members and caregivers for discharge or transfer between care settings.
- Educate members on post?transition expectations, follow-up tasks, and summaries of recent care episodes.
- Coordinate durable medical equipment (DME), transportation, and communication between care facilities and home?care teams.
- Follow established protocols, guidelines, and performance metrics to meet quality and production requirements.
- Maintain ongoing professional development, including completion of continuing education and CCM certification obligations.
Required Qualifications
- Nursing Diploma or Associate Degree in Nursing required.
- Bachelor’s Degree in Nursing strongly preferred.
- 3+ years of clinical nursing experience in clinical, acute/post?acute, or community settings required.
- 1+ year of case?management experience in a managed?care environment strongly preferred.
- Experience supporting patients telephonically and through digital channels preferred.
Certificates, Licenses, Registrations
- Current, active, unrestricted Michigan RN license required.
- CCM certification required or must be obtained within 18 months of hire.
- CCP certification preferred.
Other Skills and Abilities
- Strong critical?thinking, decision?making, and problem?solving abilities.
- Empathetic, supportive communicator and attentive listener.
- Proficient in motivational interviewing.
- Excellent time?management and organizational skills.
- Ability to manage multiple systems/tools while actively engaging with members.
- Intermediate proficiency in Microsoft Excel, OneNote, Outlook, Teams, Word, and general typing/computer navigation.
- Ability to collaborate effectively in a team environment while also performing independently.
- Strong interpersonal, verbal, and written communication skills.
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