Remote Complex Case Manager (RN) - Care Coordination

Brighton Health Plan Solutions; Chapel Hill (NC); À distance; USD 85 000 - 110 000; Plein temps

Résumé du poste

Brighton Health Plan Solutions is seeking a Complex Case Manager to oversee a caseload of members with complex medical and care coordination needs. You will coordinate across care teams, develop individualized care plans, and document outcomes to support program reporting.

This remote role requires RN licensure, strong assessment and communication skills, and experience with NCQA standards and care management practices.

Qualifications

• Strong clinical assessment, care planning, and coordination skills.
• Excellent verbal and written communication.
• Ability to work independently and manage multiple assignments.
• Proficiency with Microsoft Office and EMR systems.

Responsabilités

• Conduct comprehensive assessments to identify complex medical, psychosocial, functional, utilization, and care coordination needs.
• Develop, implement, monitor, and update individualized, member-centered care plans.
• Coordinate care across the healthcare continuum to promote quality outcomes and appropriate utilization.
• Facilitate transitions of care and support timely access to medical and community-based services.
• Maintain accurate documentation of assessments, care plans, and encounters in EMR systems.

Description du poste

Brighton Health Plan Solutions is seeking a Complex Case Manager to oversee a caseload of members with complex medical and care coordination needs. You will coordinate across care teams, develop individualized care plans, and document outcomes to support program reporting.

This remote role requires RN licensure, strong assessment and communication skills, and experience with NCQA standards and care management practices.