Remote Case Manager RN

WPS Health Solutions; Indianapolis (IN); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Remote work options available

Performance bonus or merit increase

401(k) with matching

Competitive paid time off

Health insurance and telehealth from 1

Professional and Leadership Develop.

Job summary

WPS Health Solutions is seeking a Case Management RN to coordinate care for members with complex needs and to educate families on plans of care. This role emphasizes liaison work between members, providers, and care teams.

The position requires RN licensure (Wisconsin or compact) with CM experience and a strong knowledge of care management processes. Remote options are available for several states, including Indiana.

Qualifications

• RN license in Wisconsin or valid Compact License.
• 4+ years RN experience in varied clinical settings (hospital, clinic, home care, SNF).
• 2+ years in case management.
• Experience coordinating care for case managed members.
• Strong knowledge of clinical care management processes and care coordination.
• Familiarity with health plan operations and insurance benefits.
• Proficiency with Microsoft Office and healthcare software.

Responsibilities

• Coordinate and develop member-centered care plans.
• Educate members and families about plans of care and options.
• Review prior authorization decisions for high-cost services.
• Serve as liaison between members, families and care providers.
• Document care management activities and outcomes.
• Identify barriers to care and advocate for members.

Skills

Registered Nurse

Case management

Clinical coordination

Multitasking

Analytical thinking

Communication skills

MS Office

Education

BSN

CCM certification

Tools

Microsoft Office

EMR systems

Job description

WPS Health Solutions is seeking a Case Management RN to coordinate care for members with complex needs and to educate families on plans of care. This role emphasizes liaison work between members, providers, and care teams.

The position requires RN licensure (Wisconsin or compact) with CM experience and a strong knowledge of care management processes. Remote options are available for several states, including Indiana.