Remote Case Manager RN — Care Coordination & Advocacy

WPS Health Solutions; Charlotte (NC); 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

Dental insurance

Telehealth services

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

The role requires RN licensure (Wisconsin or Compact), 2+ years case management experience, and proficiency with EMR systems. Remote work options are available for eligible states.

Qualifications

• Current RN licensure in Wisconsin or a valid Compact License.
• Experience coordinating care for case-managed members in diverse settings.
• Strong communication and interpersonal skills for member/provider collaboration.

Responsibilities

• Coordinate care across settings to develop and monitor member-centric plans.
• Educate members and families on plans of care and resources.
• Review prior authorization decisions for high-cost services.
• Serve as liaison between members, families, and providers.
• Document care management activities and report outcomes.

Skills

RN licensure

Case management

Communication

Analytical thinking

Documentation

Education

BSN preferred

CCM preferred

Tools

Microsoft Office

EMR systems

Healthcare software

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

The role requires RN licensure (Wisconsin or Compact), 2+ years case management experience, and proficiency with EMR systems. Remote work options are available for eligible states.