Case Manager, Registered Nurse

About This Opportunity

Our talent team is representing a confidential healthcare organization seeking a Case Manager, Registered Nurse for a fully remote position based in Pennsylvania. This role is central to a specialized care team supporting members with complex chronic conditions, behavioral health needs, and social determinants of health challenges. You'll spend the majority of your day engaging directly with members via phone, conducting assessments, developing individualized care plans, and coordinating across interdisciplinary teams to deliver compassionate, member-centered care.

Responsibilities

• Dedicate 50-75% of your day to telephonic member engagement and care coordination
• Compile clinical information and partner with members to develop individualized care plans with goals and interventions tailored to their needs
• Provide evidence-based disease management education and support to help members achieve health goals
• Coordinate care to ensure a seamless healthcare experience, involving appropriate interdisciplinary team members
• Maintain meticulous documentation of care management activity in electronic health records
• Collaborate with interdisciplinary care teams to address barriers to care and maintain member stability
• Identify and connect members with health plan benefits and community resources
• Meet regulatory requirements within specified timelines
• Support other care team members through clinical decision-making and guidance
• Participate in special projects, process improvement initiatives, and mentoring as assigned

What We're Looking For

Required Qualifications:

• Active and unrestricted Registered Nurse (RN) licensure in Pennsylvania OR Compact RN licensure in state of residence
• Associate's degree in Nursing (ASN) with relevant healthcare experience
• 3+ years of nursing experience
• 2+ years of case management, discharge planning, or home healthcare coordination experience
• Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams)
• Access to a private, dedicated workspace for remote work
• Confidence working independently in a virtual environment
• Strong verbal and written communication skills
• Excellent customer service and engagement abilities

Preferred Qualifications:

• Bachelor's degree in Nursing (BSN)
• Experience providing care management for Medicare and/or Medicaid members
• Experience working with individuals facing social determinants of health needs, chronic medical conditions, or behavioral health challenges
• Experience conducting health assessments and facilitating care planning
• Bilingual skills, especially English-Spanish

Essential Competencies:

• Ability to meet performance and productivity metrics, including call volume and regulatory requirements
• Strong integrity, professionalism, and self-direction
• Familiarity or willingness to learn managed care principles
• Ability to navigate healthcare technology tools effectively
• Collaborative relationship-building skills with members and colleagues

How We Work With You

When you apply through Get A Job.ai, a member of our recruiting team will review your qualifications and conduct an initial screening. If there's a strong match, we will prepare and submit your profile to our client for consideration. Please note that you should not contact the client directly—we manage all communications and coordinate next steps on your behalf throughout the interview process.

Pay

Pay details will be discussed during the screening process and are competitive with the market for this role and location.

Equal Employment Opportunity: Get A Job.ai is committed to inclusive hiring practices. We welcome applications from all qualified candidates regardless of race, color, religion, sex, national origin, age, disability, veteran status, or any other legally protected characteristic.