Remote Case Management RN — Care Coordination Lead

WPS Health Solutions; Charleston (SC); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Remote work options

Performance bonus

401(k) match

Paid time off

Health, dental, telehealth from Day 1

Professional and Leadership Dev.

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-centered plans that promote effective use of services, quality outcomes, and cost efficiency.

You will educate members and families, serve as a liaison among members, families, and providers, and ensure documentation aligns with health plan guidelines.

Qualifications

• RN licensure in WI or a compact license.
• 4+ years as a registered nurse in varied clinical settings.
• 2+ years of case management experience.
• Familiarity with health plan operations, payer/provider relationships, and insurance benefits.

Responsibilities

• Coordinate care and services for case managed members.
• Develop and monitor individualized care plans.
• Educate members and families on plans of care.
• Serve as liaison between members, families, and health care providers.
• Document care management activities and report on high risk/high utilization cases.

Skills

RN licensure (WI or Compact)

Case management experience

Analytical/problem-solving

Communication/interpersonal skills

Care coordination

Education

Bachelor's degree in nursing (BSN)

Certified Case Manager (CCM) preferred

Tools

Microsoft Office

EMR systems

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-centered plans that promote effective use of services, quality outcomes, and cost efficiency.

You will educate members and families, serve as a liaison among members, families, and providers, and ensure documentation aligns with health plan guidelines.