Remote Case Management RN - Care Coordinator

WPS Health Solutions; Atlanta (GA); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus/merit increase

401(k) with 100% match up to 3% and 50

Paid time off

Health and dental insurance

Telehealth services

Professional and LeadershipDevelopment

Job summary

WPS Health Solutions is seeking a Case Management Registered Nurse to coordinate care for members with complex health needs across the continuum. The role emphasizes developing and monitoring member-centric plans of care, educating members and families, and acting as a liaison among members, providers, and care teams.

The ideal candidate has 4+ years of RN experience, 2+ years in case management, and familiarity with health plan operations.

Qualifications

• Registered Nurse (RN) with current licensure in Wisconsin or a Compact License.
• 4+ years of experience as an RN in varied clinical settings (hospital, clinic, home care, SNF, etc.).
• 2+ 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.
• Ability to work independently, manage a caseload, and prioritize; strong analytical and communication skills; proficient in Microsoft Office and healthcare software.

Responsibilities

• Coordinate care and services for members with complex health care needs.
• Develop and monitor member-centric plans of care.
• Educate members and families on plans of care.
• Act as liaison between members, families and health care providers.
• Support transitions of care and site of care redirections as needed.
• Identify barriers to care and advocate for member needs and preferences.
• Document care management activities and analyze outcomes for high-risk/high-cost cases.

Skills

RN licensure (Wisconsin or Compact)

Case management experience

Care coordination

Communication skills

Microsoft Office

Education

RN degree (BSN preferred)

Nursing degree (RN)

Tools

EMR systems

Healthcare software & systems

Job description

WPS Health Solutions is seeking a Case Management Registered Nurse to coordinate care for members with complex health needs across the continuum. The role emphasizes developing and monitoring member-centric plans of care, educating members and families, and acting as a liaison among members, providers, and care teams.

The ideal candidate has 4+ years of RN experience, 2+ years in case management, and familiarity with health plan operations.