Case Manager

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Coordinate care, resources, and/or services for designated member populations

• Participate in a multidisciplinary team to achieve optimal clinical and resource outcomes

• Conduct thorough assessments and develop treatment, intervention, and discharge plans centered around members

• Identify obstacles to achieving care goals and leverage community resources and funding sources

• Monitor and manage members through scheduled follow-ups, education, referrals, documentation, and adjustments to plans

• Evaluate and facilitate care throughout the continuum, including physician offices, hospitals, rehabilitation units, skilled nursing facilities, and home care

• Educate members and promote proactive interventions to minimize expenses and encourage positive outcomes

• Document assessments, planning, implementation, monitoring, and results

• Reach out to high-risk, high-cost, or high-utilization members as necessary

• Assess alternative treatment plans, benefits, exceptions, and flex benefit options as required

• Evaluate the medical necessity and suitability of services

• Develop policies, procedures, educational materials, or training as needed

⛳️ Requirements

• RN with a minimum of 3 years of clinical and/or case management experience is required

• Must possess and maintain a valid and applicable clinical license (NC or compact multi-state licensure)

• For certain positions, additional specialty certification (e.g., CCM, CDCES) may be needed; relevant certification must be acquired within 2 years of employment if required

• Additional non-compact state nursing licenses are highly preferred

• Extensive clinical nursing experience across various care settings is strongly desirable, including Medical-Surgical, ICU, Emergency Department, Pediatrics, Labor & Delivery, and other inpatient specialties

🏝️ Benefits

• Medical, dental, and vision coverage

• Health and wellness programs

• Parental leave and support

• Adoption and surrogacy assistance

• Career development programs

• Tuition reimbursement for further education

• 401k match including an annual company contribution

• Annual Incentive Bonus

• Paid Time Off (PTO)

• Flexible work arrangements

• Work-life balance and autonomy