Case Management RN

Remote; San Francisco (CA); Remote; USD 85,000 - 115,000; Full time

Job summary

Remote in San Diego County is seeking a Case Management RN to coordinate cross-disciplinary care plans and advocate for patients across the continuum of care. You will monitor progress, liaise with healthcare providers and insurers, and implement plans that connect patients with needed resources while ensuring compliance with medical recommendations.

You will deliver nursing triage by phone, support on-call coverage, and stay current with agency policies and procedures.

Qualifications

• Active California RN license.
• At least one year of RN experience.
• At least one year in Women's Healthcare.
• Willingness to complete orientation in surgical and family planning settings.
• Strong communication, critical thinking and patient advocacy in a remote environment.
• Must reside in San Diego County.

Responsibilities

• Provide professional telephonic nursing assessment, evaluation, education, and advice per agency protocols.
• Coordinate care plans and liaise with patients, providers, and insurance partners.
• Manage lab/imaging results, referrals, prescriptions, prior authorizations and follow-ups.
• Support timely patient calls while preserving high-quality, patient-centered care.
• Maintain knowledge of agency policies, protocols, and regulatory requirements.
• Coordinate ongoing patient needs with providers and external partners.
• Advocate for patients to access appropriate services and resources.
• Participate in on-call responsibilities per agency guidelines.

Skills

Communication skills

Critical thinking

Patient advocacy

Independent work (remote)

Education

Registered Nurse (RN) license

Job description

Join our team as a Case Management RN, where you'll play a key role in coordinating patient care, advocating for patient needs, and serving as a trusted resource throughout the continuum of care.

In this role, you will coordinate interdisciplinary care plans, monitor patient progress, and serve as a liaison between patients, healthcare providers, and insurance partners to ensure effective, patient-centered care. You will develop and implement care management plans that connect patients with appropriate resources, support compliance with medical recommendations, and address ongoing healthcare needs. The position also provides professional nursing triage services and health guidance by phone, as well as on-call support in accordance with agency guidelines.

This is a full-time remote position; however, candidates must reside in San Diego County.

Schedule: Four 10-hour shifts per week (4/10s)

Available Rotations:

Option Rotation #1

• Week 1: Monday, Wednesday, Friday, Saturday

• Week 2: Monday, Tuesday, Wednesday, Thursday

Option Rotation #2

• Week 1: Monday, Tuesday, Wednesday, Friday

• Week 2: Tuesday, Thursday, Friday, Saturday

In this role, you'll get to:

• Provide professional, comprehensive telephonic nursing assessment, evaluation, education, and advice to patients in accordance with agency protocols.

• Participate in health center efforts to achieve established goals related to productivity, quality metrics, and revenue cycle performance.

• Manage lab and imaging results, referrals, prescription refills, prior authorizations, and other patient follow-up activities in accordance with agency medical protocols and case management policies and procedures.

• Support timely completion of patient calls and follow-up activities while delivering high-quality, patient-centered care and maintaining operational efficiency.

• Maintain current knowledge of agency and department policies, protocols, procedures, regulatory requirements, and best practices.

• Coordinate ongoing patient care needs and collaborate with providers, clinical staff, and external partners to ensure continuity of care.

• Serve as a patient advocate by helping patients navigate healthcare resources, understand treatment plans, and access appropriate services.

• Participate in on-call responsibilities in accordance with agency guidelines.

What we're looking for:

• Active California RN license.

• At least one year of experience working as a Registered Nurse.

• At least one year of experience in Women's Healthcare.

• Willingness to complete orientation in both surgical and family planning settings to gain a thorough understanding of clinic operations and patient care workflows.

• Strong communication, critical thinking, patient advocacy, and independent work skills in a remote environment

• Must reside in San Diego County.