Case Manager – NLC

Overview

We are representing a confidential health services organization seeking an experienced Case Manager to join their remote team. This role focuses on applying the six essential activities of case management—assessment, planning, implementation, coordination, monitoring, and evaluation—to support members across multiple states through quality improvement functions and comprehensive care coordination.

As part of our talent team at Get A Job.ai, we work with leading healthcare organizations to identify skilled nursing professionals who can deliver exceptional case management services in a virtual care environment.

Responsibilities

• Assess patients' immediate and long-term needs through comprehensive evaluation of social and medical history
• Develop individualized care plans considering physical and psychosocial needs, benefit plans, and cost-benefit analysis factors
• Continuously evaluate and monitor care plans based on changing patient needs and care effectiveness across the interdisciplinary team
• Ensure compliance with regulatory and privacy standards while coordinating decision-making and documentation processes
• Establish professional relationships with interdisciplinary team members and communicate case objectives to all involved parties
• Act as a patient advocate, identifying potential complications and understanding physical and psychosocial illness characteristics
• Research and coordinate community resources to assist patients in achieving maximum psychological, social, and physical recovery
• Identify cases benefiting from alternative care options and implement alternatives considering quality and ongoing patient needs
• Work with payors and providers to evaluate quality and cost-effectiveness of services, negotiating discounts when appropriate
• Document patient care plans in a timely manner and maintain accurate databases
• Apply problem-solving techniques to the case management process and implement alternatives when needed
• Maintain professional status through continuing education and professional organization membership

What We're Looking For

• Active, current, unrestricted Registered Nurse (RN) license in a Nurse Licensure Compact (NLC) state required
• Bachelor's degree preferred
• Case Management Certification (CCM) required, or ability to obtain within three (3) years of hire
• Three (3) years of clinical RN experience in med/surg or ambulatory care setting required
• Clinical experience in Behavioral Health, Transplant, Neo-Natal, or Oncology preferred
• Previous managed care experience a plus
• Strong clinical knowledge of health or social work needs for diverse populations
• Ability to identify barriers to successful care management paths
• Effective interaction skills with physicians and healthcare team members
• Excellent problem-solving abilities and time management skills
• Outstanding written, verbal, and interpersonal communication skills
• Ability to work independently and proficiently with flexibility in schedules and assignments
• Knowledge of ADA principles and federal legislation affecting individuals with disabilities
• Understanding of assistive and adaptive equipment

Please note: Immigration or work visa sponsorship will not be provided for this position.

How We Work with You

When you apply through Get A Job.ai, our recruiting team will review your qualifications and conduct an initial screening. If your background aligns with our client's needs, we will submit your profile to them for consideration and guide you through each step of the interview process. We ask that you do not contact the client directly, as all communication will be coordinated through our team to ensure the best experience for everyone involved.

Pay

The client has indicated a compensation range of $35.50 - $38.00 hourly for this role. Compensation may vary based on skills, education, location, and experience. Additional benefits may include scorecard incentives, comprehensive benefits packages, and generous paid time off.

Equal Employment Opportunity: Get A Job.ai is committed to equal employment opportunity and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic under applicable law.