Registered Nurse Case Manager - Remote - WFH

Our mission is to enhance healthcare affordability for patients and restore the fulfillment of practicing medicine for providers. As a physician-led organization, we streamline administrative tasks and leverage predictive analytics and AI to enable our partner physician practices to focus on delivering high-quality healthcare centered on outcomes and value.

About The Role As an RN Case Manager, you will collaborate closely with clinical teams to provide comprehensive case management and strengthen the connection between patients and primary care physicians or medical practice staff. You will be responsible for managing a specific patient population, which includes individuals with complex medical conditions, socio-economic challenges, and/or mental health co-morbidities. Your role will focus on optimizing patients' health through thorough assessment, personalized care planning, and coordination of available services.

Working alongside approximately 5 patient care navigators and other members of the care team, you will strive to achieve optimal quality, clinical, and financial outcomes. Key Responsibilities Conduct comprehensive assessments of healthcare and psychosocial needs for patients. Develop, implement, and maintain individualized care plans in alignment with internal protocols and accreditation standards.

Provide evidence-based clinical interventions based on care plan goals. Collaborate with patient navigators to manage non-clinical aspects of care plans (e.g., appointments, transportation, social determinants of health). Monitor patient data continuously and adjust care plans as necessary. Develop patient-specific escalation plans in collaboration with primary care physicians.

Educate patients on conditions and treatment options. Serve as a patient advocate, facilitating access to necessary services and resources. Follow up on referrals to services or resources.

Maintain accurate documentation in electronic medical health records as per protocol. Utilize evidence-based clinical protocols and guidelines to achieve defined quality metrics. Required Qualifications Licensed Registered Nurse (RN) in good standing. 3 years of RN Case Management experience in an outpatient setting.

CCM certification preferred; must obtain CCM within [recommend 1 year] of employment.

Supervisory Experience Preferred. Excellent written and oral communication skills for empathetic patient interaction and interdisciplinary collaboration.

Strong computer skills, including proficiency in multiple EMR and Case Management documentation systems. Ability to meet accreditation and quality standards such as NCQA and HEDIS. Preferred Qualifications Bilingual in English and Spanish preferred.

Compensation Offers a competitive compensation package including a base salary range of $80,000 to $85,000 per year, paid bi-weekly according to standard payroll practices. Additional benefits include comprehensive medical, dental, and vision plans, long and short-term disability, life insurance, and a 401k plan with a generous match. Our paid time off program includes holidays and flexible time to support work-life balance.

Equal Opportunity Employer Diversity, inclusion, and belonging are fundamental to our values. We are an equal opportunity employer committed to making employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth, or other related medical conditions. We uphold this policy across all aspects of employment.

Security Commitment This position requires adherence to all security policies and procedures to safeguard Protected Health Information (PHI) under custodianship, as well as our intellectual properties. Employment Type: Full-Time