Remote Case Management RN | Care Coordination Expert

WPS Health Solutions; Des Moines (IA); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and/or merit raise

401(k) with 100% match for the first 3

50% match for the next 2% of salary (1

Paid time off

Health insurance, dental, telehealth

Professional and LeadershipDevelopment

Job summary

WPS Health Solutions is seeking a Case Management RN to coordinate care for members with complex needs. You will develop and monitor member-centric plans of care, educate families, and liaise with providers to optimize health outcomes and cost-efficiency.

The role requires a current RN license (WI or Compact), 4+ years in varied clinical settings, and 2+ years in case management. Remote work options are available for approved states.

Qualifications

• Active RN license in Wisconsin or a current Compact license.
• 4+ years of RN experience in varied clinical settings.
• 2+ years in case management.
• Experience coordinating care and utilization management.

Responsibilities

• Develop and monitor member-centric care plans.
• Educate members and families on plans of care.
• Review prior authorization decisions for high-cost services.
• Coordinate transitions of care across settings and manage barriers to care.

Skills

Registered Nurse licensure

Case management experience

Patient advocacy & communication

Analytical & problem-solving

Microsoft Office

EMR/healthcare software proficiency

Education

Bachelor's degree in nursing (BSN)

Registered Nurse license (state of WI or Compact)

Tools

EMR systems

Healthcare software suites

Microsoft Office Suite

Job description

WPS Health Solutions is seeking a Case Management RN to coordinate care for members with complex needs. You will develop and monitor member-centric plans of care, educate families, and liaise with providers to optimize health outcomes and cost-efficiency.

The role requires a current RN license (WI or Compact), 4+ years in varied clinical settings, and 2+ years in case management. Remote work options are available for approved states.