Job Title:
Nurse Case Management Senior Analyst
Location:
United States
Job Type:
Contract
Expected Hours per Week:
40 hours per week
Schedule:
9 AM – 5 PM, Monday–Friday, weekend work if needed, remote
Pay Range:
$45.50 per hour
Role Overview
We’re seeking an experienced RN Case Management Senior Analyst to independently manage complex cases and support high?quality, cost?effective healthcare outcomes across the continuum of care.
What You’ll Do
- Independently manage an assigned caseload using advanced nurse case management and utilization management principles
- Assess, plan, implement, coordinate, and evaluate healthcare services in collaboration with physician treatment plans
- Perform prospective, concurrent, and retrospective utilization reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services
- Conduct comprehensive clinical assessments and provide member education to support optimal outcomes
- Evaluate alternative care options to ensure quality, medically appropriate, and cost?effective care
- Monitor case progress, identify risks or gaps in care, and proactively address non?routine or escalated issues
- Support program objectives by measuring the effectiveness of care plans and services
- Serve as a clinical resource for less?experienced team members while working independently with minimal supervision
What You Bring
- Active, unrestricted RN license
- Clinical case management and utilization management experience
- Experience reviewing inpatient acute admissions and levels of care
- Strong clinical judgment and ability to work independently
- Comfort managing a full caseload with forward planning and prioritization
- Excellent communication and collaboration skills
Why This Role
- Senior?level autonomy with meaningful clinical impact
- Focus on quality outcomes and care coordination rather than bedside nursing
- Opportunity to resolve complex, non?routine cases
- Collaborative environment with access to experienced peers
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