Remote Case Management RN: Patient-Centric Care

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

Benefits offered by this job

Remote work options

Performance bonus

401(k) with match

Paid time off

Health insurance

Job summary

WPS Health Solutions is seeking a Case Management Registered Nurse to coordinate care for members with complex health needs. You will develop and monitor member-centric care plans and educate members and families on plans of care.

The role involves acting as liaison with providers, reviewing high-cost service authorizations, and documenting care activities while ensuring compliance with regulations. Remote work is available in approved states and requires reliable connectivity.

Qualifications

• Registered Nurse with active licensure and 4+ years in varied settings.
• 2+ years in case management and care coordination.
• Strong knowledge of clinical care management processes and payer/ provider relationships.
• Ability to work independently with a caseload and prioritize tasks.

Responsibilities

• Coordinate care across settings and develop member-centric plans.
• Educate members and families on plans of care and available resources.
• Review prior authorization decisions for high-cost services.
• Serve as liaison among members, families, and health care providers.
• Document activities and analyze care management data for riskiest cases.

Skills

Care coordination

Analytical thinking

Communication skills

Time management

Independent work

Education

Bachelor’s degree in nursing (BSN)

RN licensure (Wisconsin or Compact)

Tools

EMR systems

Microsoft Office

Job description

WPS Health Solutions is seeking a Case Management Registered Nurse to coordinate care for members with complex health needs. You will develop and monitor member-centric care plans and educate members and families on plans of care.

The role involves acting as liaison with providers, reviewing high-cost service authorizations, and documenting care activities while ensuring compliance with regulations. Remote work is available in approved states and requires reliable connectivity.