Remote Case Management RN - Care Coordination Lead

WPS Health Solutions; Omaha (NE); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Remote work options

Bonus opportunities

401(k) with match

Competitive PTO

Health/dental/telehealth

Job summary

WPS Health Solutions is seeking a Case Management RN to coordinate care for members with complex health needs. You will educate patients and families, liaise with providers, and manage approvals for high-cost services while ensuring quality and cost-effective outcomes. Remote work options are available in approved states.

Ideal candidates hold RN licensure (WI or Compact), 4+ years of nursing and 2+ years of case management, with strong communication and EMR skills. BSN preferred.

Qualifications

• Registered Nurse with current licensure in Wisconsin or a Compact license.
• 4+ years RN experience in varied clinical settings.
• 2+ years case management experience.
• Experience managing and coordinating care for case managed members.
• Familiarity with health plan operations and payer/provider relationships.
• Strong communication and interpersonal skills; ability to work cross functionally.

Responsibilities

• Coordinate care across providers and settings for high-need members.
• Educate members and families on plans of care and resources.
• Review and authorize high-cost services (e.g., transplant, dialysis).
• Advocate for member needs, address barriers to care, and coordinate transitions of care.
• Document care management activities and report on high-risk cases.

Skills

RN licensure

Case management

Communication

Analytical thinking

Independent work

Education

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. You will educate patients and families, liaise with providers, and manage approvals for high-cost services while ensuring quality and cost-effective outcomes. Remote work options are available in approved states.

Ideal candidates hold RN licensure (WI or Compact), 4+ years of nursing and 2+ years of case management, with strong communication and EMR skills. BSN preferred.