Remote Case Management RN | Care Coordination Expert

WPS—A health solutions company; Minnesota; Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus and/or merit

401(k) with match

Competitive PTO

Health insurance and telehealth

Professional and Leadership Developmen

Additional benefits review

Job summary

WPS—A health solutions company in the United States is seeking a Case Management RN to coordinate care for members with complex health needs. You will develop and monitor a member-centric plan of care and educate families on plans of care, acting as a liaison among members, families and providers.

The role involves coordinating care transitions, facilitating site-of-care redirections, and addressing barriers to care while ensuring compliance with regulations and payer requirements.

Qualifications

• Registered Nurse (RN) with current licensure in the state of Wisconsin OR current Compact License.
• 4 or more years of experience as a Registered Nurse in varied clinical settings (i.e., hospital, clinic, home care, skilled nursing facility, etc.).
• 2 or more years of case management experience.
• Demonstrated experience managing and coordinating care effectively for case managed members.
• Strong knowledge of clinical care management processes, care coordination, and case management principles.
• Familiarity with health plan operations, payer/provider relationships, and insurance benefits.
• Independent work capability, prioritization and strong analytical, problem-solving, and decision-making skills.
• Excellent communication and interpersonal skills to work with members, providers, and teams.
• Proficiency in Microsoft Office and healthcare software and systems.

Responsibilities

• Coordinate care and services for members with complex health care needs.
• Educate members and families on plans of care and advocate for their needs.
• Serve as liaison between members, families and health care providers.
• Manage and coordinate care transitions and site-of-care redirections as needed.
• Identify barriers to care and address them to improve wellness and autonomy.
• Document care management activities and report on high-risk or high-utilization cases.

Skills

Case management

Care coordination

Analytical thinking

Communication skills

Independent work

Education

RN license in Wisconsin

BSN preferred

Compact license

Tools

Microsoft Office

EMR systems

Healthcare software

Word processing

Spreadsheets

Job description

WPS—A health solutions company in the United States is seeking a Case Management RN to coordinate care for members with complex health needs. You will develop and monitor a member-centric plan of care and educate families on plans of care, acting as a liaison among members, families and providers.

The role involves coordinating care transitions, facilitating site-of-care redirections, and addressing barriers to care while ensuring compliance with regulations and payer requirements.