Remote Case Manager II RN Care Coordinator

Superior Dental Care, Inc.; Cleveland, Northern (OH, KY); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

401(k) with company match

PTO and parental leave

Job summary

Medical Mutual is seeking a nurse case manager for a remote-based role focused on guiding members, families, and physicians through care options and barriers. The position emphasizes coordinated care, documentation, and collaboration within the health plan framework.

The ideal candidate has an Ohio RN license with 3+ years of clinical/case management experience, preferably in health insurance, and may hold CCM certification. Strong communication and HIPAA knowledge are essential for success.

Qualifications

• RN license in Ohio; CCM or similar certification preferred.
• Minimum 3 years as an RN with clinical and case management experience; health insurance experience preferred.
• Home health care experience is a plus.
• Experience in the health insurance industry is preferred.
• Knowledge of HIPAA and regulatory guidelines; strong communication skills.

Responsibilities

• Manage complex health care cases via phone, email, and video.
• Verify eligibility, benefits, enrollment history, clinical history, and demographics.
• Educate members and families on care options and barriers to care.
• Coordinate services with community resources and support groups.
• Document accurately per policies and procedures; train junior staff as needed.

Skills

Health coaching

Motivational interviewing

Behavioral change

HIPAA

Care coordination

Education

RN license (Ohio)

CCM or equivalent

Motivational Interviewing cert (preferred)

Tools

Microsoft Office

Job description

Medical Mutual is seeking a nurse case manager for a remote-based role focused on guiding members, families, and physicians through care options and barriers. The position emphasizes coordinated care, documentation, and collaboration within the health plan framework.

The ideal candidate has an Ohio RN license with 3+ years of clinical/case management experience, preferably in health insurance, and may hold CCM certification. Strong communication and HIPAA knowledge are essential for success.