Job Title
Case Manager RN
Location
Fully Remote (Michigan preferred)
Schedule
Remote
Type
Full-Time 12-month Ongoing Contract
Pay Range
$35–38/hour
Summary
Seeking a Case Manager RN to lead care coordination for a diverse health plan population with complex medical and social needs. This role serves as the primary point of contact for members, caregivers, and providers, delivering a holistic, person-centered care management program. The Case Manager RN will utilize clinical expertise and the case management process to assess, develop, implement, and monitor care plans that improve health outcomes across the care continuum.
Key Responsibilities
- Lead coordination of a multidisciplinary team (including Social Workers, Dietitians, Pharmacists, Clinical Support, and Medical Directors) to deliver comprehensive care services
- Assess members’ medical, behavioral, psychosocial, and cultural needs to develop individualized care plans
- Implement, monitor, and evaluate care plans to ensure progress toward health goals
- Engage members and caregivers to address barriers, close gaps in care, and promote improved outcomes
- Coordinate services across providers, community agencies, and family support systems
- Arrange appropriate resources including mental health, substance abuse, financial, and disease-specific services
- Advocate for members while promoting self-advocacy and health literacy
- Provide education on self-management, medications, and nutrition
- Monitor adherence to care plans and adjust as needed
- Document all member interactions accurately and in a timely manner
- Support transitions of care, including discharge planning and coordination to home or other facilities
- Secure durable medical equipment and transportation as needed
- Educate members on post-care follow-up and continuity of care
- Maintain compliance with quality standards, protocols, and productivity goals
- Participate in ongoing professional development and continuing education
Required Qualifications
- Nursing Diploma or Associate Degree in Nursing
- Minimum 3+ years of clinical nursing experience (acute, post-acute, or community setting)
- Active, unrestricted Michigan Registered Nurse (RN) license
- Strong critical thinking, problem-solving, and decision-making skills
- Excellent communication and interpersonal skills
- Ability to manage multiple systems and workflows while engaging members
Preferred Qualifications
- Bachelor’s Degree in Nursing (BSN)
- 1+ year of case management experience in a managed care setting
- Experience managing patients telephonically and through digital channels
- Certification in Case Management (CCM) or ability to obtain within 18 months
- Chronic Care Professional (CCP) certification
Skills & Competencies
- Strong organizational and time management skills
- Proficiency in Microsoft Office (Excel, Word, Outlook, Teams, OneNote)
- Ability to work independently and collaboratively within a team
- Experience with motivational interviewing techniques
- Empathetic approach with strong listening skills
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