Remote Case Management RN – Care Navigator

WPS Health Solutions; Houston (TX); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Remote work options available

401(k) match

Competitive PTO

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-centric plans, educate members and families, and liaise with providers to ensure high-quality, cost-efficient care.

The role requires RN licensure (Wisconsin or Compact License) and 4+ years of RN experience, with 2+ years in case management. Remote work options are available for qualified states.

Qualifications

• Registered Nurse (RN) 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, payer/provider relationships, and insurance benefits.
• Proficiency in Microsoft Office and healthcare software/systems.

Responsibilities

• Coordinate care and services for members with complex health care needs.
• Develop and monitor member-centric care plans to promote quality and cost-efficiency.
• Educate members and families on plans of care and serve as liaison among members, families and providers.

Skills

Care coordination

Communication skills

Analytical thinking

Time management

Advocacy

Education

RN licensure (Wisconsin or Compact)

BSN (preferred)

Tools

Microsoft Office

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-centric plans, educate members and families, and liaise with providers to ensure high-quality, cost-efficient care.

The role requires RN licensure (Wisconsin or Compact License) and 4+ years of RN experience, with 2+ years in case management. Remote work options are available for qualified states.