Remote Case Management RN: Care Coordination & Advocacy

WPS Health Solutions; Green Bay (WI); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and merit increases

401(k) with generous matches

Competitive PTO

Health, dental, and telehealth fromDay

Job summary

WPS Health Solutions is seeking a Case Management RN to coordinate care for members with complex health needs. You will develop and monitor member-centric plans of care, educate members and families, and act as a liaison between members, families and providers.

The ideal candidate has 4+ years RN experience, 2+ years in case management, and strong knowledge of care management processes and health plan operations. Remote work is available in specified states.

Qualifications

• Registered Nurse (RN) with Wisconsin licensure or Compact License.
• 4+ years of RN experience in varied clinical settings.
• 2+ years of case management experience.
• Demonstrated ability to manage and coordinate care for case managed members.
• Strong knowledge of care management processes and care coordination.
• Familiarity with health plan operations and insurance benefits.
• Ability to work independently, manage caseload, and prioritize tasks.
• Excellent analytical, critical thinking, and communication skills.

Responsibilities

• Coordinate care and services for members with complex health needs.
• Educate members and families on plans of care.
• Serve as liaison between members, families, and providers.
• Document care management activities and report on high-risk cases.
• Ensure compliance with health plan guidelines and regulatory standards.
• Collaborate cross-functionally to support department goals.

Skills

Case management

RN experience

Care coordination

Utilization management

Communication skills

EMR proficiency

Analytical skills

MS Office

Education

Wisconsin RN license

Compact License

BSN

Tools

EMR systems

Microsoft Office

Healthcare software

Job description

WPS Health Solutions is seeking a Case Management RN to coordinate care for members with complex health needs. You will develop and monitor member-centric plans of care, educate members and families, and act as a liaison between members, families and providers.

The ideal candidate has 4+ years RN experience, 2+ years in case management, and strong knowledge of care management processes and health plan operations. Remote work is available in specified states.