Remote Case Management RN | Care Coordination Expert

WPS Health Solutions; Hampton (VA); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Remote work options

Performance bonus

401(k) with match

Job summary

WPS Health Solutions is seeking a Case Management RN to coordinate care for members with complex health needs and develop member-centric plans of care. You will educate members and families, serve as liaison with providers, and oversee authorization decisions for selective high‑cost services.

The role requires RN licensure, 4+ years of nursing experience, and 2+ years in case management. Remote work is available in approved states, including Virginia.

Qualifications

• Registered Nurse with current licensure in Wisconsin or a Compact license.
• 4+ years of RN experience in varied clinical settings.
• 2+ years of case management experience.
• Familiarity with health plan operations and payer-provider relationships.

Responsibilities

• Coordinate care and services for case managed members.
• Educate members and families on plans of care.
• Review and decide on prior authorizations for high-cost services.
• Document care management activities and track high-risk cases.

Skills

Case management

Communication

Analytical thinking

Independent work

Prioritization

Education

RN licensure (Wisconsin or Compact)

BSN (preferred)

Tools

EMR systems

Microsoft Office

Job description

WPS Health Solutions is seeking a Case Management RN to coordinate care for members with complex health needs and develop member-centric plans of care. You will educate members and families, serve as liaison with providers, and oversee authorization decisions for selective high‑cost services.

The role requires RN licensure, 4+ years of nursing experience, and 2+ years in case management. Remote work is available in approved states, including Virginia.