Case Manager

TalentLNX; United States; Remote; USD 75,000 - 90,000; Full time

Job summary

TalentLNX is seeking a detail-oriented Case Manager, Registered Nurse to oversee patient care coordination across the healthcare continuum. The ideal candidate will manage complex cases, utilize resources efficiently, and collaborate closely with healthcare providers. Candidates must possess a valid RN license and several years of nursing experience, particularly in case management.

Qualifications

• Current RN license and multi-state compact license preferred.
• Minimum 3 years nursing experience with 1–2 years in case management or utilization review.
• Experience with healthcare insurance authorization processes required.

Responsibilities

• Assess patient needs and develop comprehensive care plans.
• Coordinate care across providers and facilities.
• Monitor patient progress and adjust care plans as necessary.

Skills

Clinical assessment

Critical thinking

Communication

Organizational skills

Education

Current RN license in state of residence

3 years nursing experience

Tools

Electronic medical records

Microsoft Office

Job description

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TalentLNX provided pay range

This range is provided by TalentLNX. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$75,000.00/yr - $90,000.00/yr

Position Overview:

We are seeking a detail-oriented and clinically proficient Case Manager, Registered Nurse to oversee the coordination of patient care across the healthcare continuum. This role involves managing complex cases, ensuring appropriate utilization of resources, facilitating authorizations, and collaborating closely with providers, patients, and payers. The ideal candidate is an experienced RN with strong clinical judgment, exceptional organizational skills, and a comprehensive understanding of healthcare regulations and insurance processes.

Please Note:

Candidates must hold a valid RN license in their state of residence. Multi-state licensure or eligibility to obtain additional licenses is preferred. A HIPAA-compliant home office and reliable internet connection are required.

Responsibilities:

• Assess patient needs and develop comprehensive care plans based on clinical findings and organizational guidelines
• Coordinate care across providers, facilities, and payers to optimize resource use and patient outcomes
• Facilitate authorization and approval processes for treatments, procedures, and services with insurance providers
• Monitor patient progress and clinical outcomes, adjusting care plans as necessary
• Conduct utilization review and ensure compliance with regulatory and payer requirements
• Communicate effectively with interdisciplinary care teams, patients, and families regarding care plans and clinical status
• Document all case management activities accurately and timely in electronic health records
• Identify and address barriers to care including social determinants impacting health
• Meet established productivity, quality, and compliance standards
• Participate in training, team meetings, and continuous quality improvement initiatives

Qualifications:

• Current RN license in state of residence; multi-state compact license preferred
• Minimum 3 years nursing experience, with 1–2 years in case management or utilization review strongly preferred
• Strong clinical assessment and critical thinking skills
• Experience with healthcare insurance authorization processes and utilization management
• Proficient in electronic medical records and Microsoft Office applications
• Excellent communication and organizational skills
• Ability to work independently in a remote setting and manage multiple priorities
• Full-time, Monday through Friday, standard business hours
• Remote work with HIPAA-compliant home office

Salary Range:

$75,000 to $90,000 annually, dependent on experience and licensure status.

Interview Process:

• Initial Screening Call with TalentLNX
• Phone Interview
• Final Video Interview

Equal Opportunity Employer:

TalentLNX is committed to equal employment opportunity and prohibits discrimination and harassment of any kind. We are dedicated to building a diverse workforce and fostering an inclusive work environment where all employees and candidates are treated with respect and dignity. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or any other protected status under applicable law. We actively seek to recruit, develop, and retain talented individuals from diverse backgrounds, and we encourage all qualified candidates to apply for our job opportunities.

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Customer Service

• Industries

  Hospitals and Health Care

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