Case Management Nurse (RN)

LanceSoft Inc.,; Miami (FL); Remote; Full time

Job summary

A leading company is seeking a Case Manager to facilitate health services and support members in Miami-Dade County. The role involves conducting assessments, coordinating care, and ensuring successful transitions for members. Ideal candidates will have clinical experience, be bilingual in Spanish and English, and be willing to travel locally. This contract position offers a competitive pay range and the opportunity to make a significant impact in the community.

Qualifications

• Minimum 2 years of clinical experience.
• RN with current unrestricted state licensure.
• Bilingual Spanish/English required.

Responsibilities

• Complete at least 10 NF member assessments weekly.
• Support the Health Plan Rebalancing Initiative.
• Conduct in-person visits and follow-up on member transitions.

Skills

Critical thinking

Bilingual Spanish/English

Clinical assessment

Community engagement

Education

RN with current unrestricted state licensure

Tools

Computer skills

Job description

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Estimated Length of Assignment: 06/30/2025 to 12/26/2025. The dates provided are only an estimate and not a guarantee.

Est. Pay Range: $38.00/hr. to $40.00/hr.

Work Type: Remote with travel in Miami-Dade County.

Position Summary:

The Case Manager utilizes a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

Duties:

1. Complete at least 10 NF member assessments weekly
2. Support the Health Plan Rebalancing Initiative goal of successful transitions: Assess, identify, screen, and transition NH members into the community
3. Follow up on CM referrals and visit current NH members in-person at least twice a week to complete the rebalancing events and screening assessments.
4. Complete telephonic or in-person contact to assess the home prior to discharge and identify any environmental supports needed to support transition (i.e., ramp, DME installation, etc.).
5. Conduct an in-person Significant Change Visit with member and Rep if applicable, within 5 days of transition. Coordinate provision of services as needed, establish Plan of Care, and document all actions taken.
6. Contact facility’s Business Office once a week to follow-up on member’s census and coordinate with Social Services and CM to facilitate discharge.
7. Work collaboratively with case managers to identify high-risk community members and implement appropriate interventions to prevent lapse or coordinate safe transition (Upon receiving referral)
8. Drive enhanced value of health care to increase member satisfaction and retention and drive new membership growth.
9. Be involved in at least two community relations events per year
10. Engage in building strong relationships that contribute towards member satisfaction and retention

Required Qualifications:

• Candidate must reside in Orlando area and will service Orange, Osceola, Brevard, & Seminole Counties and be able to travel to facilities within the regions/neighboring counties. Hours required are M - F 8am - 5 pm EST with some flexibility for start/stop times. Local travel up to 75%. Applies critical thinking, evidence-based clinical criteria to support contractual rebalancing goals.
• Candidate must reside in FL and area of coverage.
• Minimum 2 years of clinical experience
• Bi-Lingual Spanish/English required.
• Willing and able to travel 75% of their time to meet members face to face and surrounding counties/areas.

Preferred Qualifications:

• Managed Care Experience.
• Transition of care experience.
• Proficiency with computer skills, including navigating multiple systems.
• Ability to work in a fast-paced environment

Experience Level: Mid-level

Education:

• RN with current unrestricted state licensure.

Seniority level

• Entry level

Employment type

• Contract

Job function

• Health Care Provider

Industries

• IT Services and IT Consulting