Remote RN Case Manager - Care Coordination

Guidewell; Irving (TX); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability programs

Retirement Savings Plan with employer

Paid time off and holidays

Job summary

GuideWell, Inc. is seeking an RN Case Manager in the Irving, TX area to design, implement and monitor treatment plans that meet patients’ healthcare goals. You will assess needs, coordinate interdisciplinary options, and navigate benefit structures to optimize care.

The role requires 5+ years nursing experience, a nursing degree, and an active RN license. You’ll collaborate across teams, manage cost-conscious care plans, and report outcomes to clients and stakeholders.

Qualifications

• 5+ years related work experience with a professional background in clinical nursing and patient assessment.
• Related Bachelor’s degree or additional related equivalent work experience
• Graduate of an accredited school of nursing
• RN - Registered Nurse - State Licensure
• Knowledgeable in medical terminology, reasonable and necessary treatment plans, delivery quality health care services and cost containment practices.
• Ability to collaborate with cross-operational areas within the organization.

Responsibilities

• Assess member health status and care coordination needs, including potential inpatient review and discharge planning.
• Contact patients, families, physicians, and providers to coordinate care and resources.
• Identify and obtain approval for alternative treatment plans based on quality care and cost containment.
• Assess clinical status and adjust care plans to meet changing health needs.
• Identify services, providers, and facilities to serve members timely and cost-effectively.
• Develop and implement short- and long-term case management goals with documented care plans.
• Use technology to evaluate cost-effectiveness of chosen treatment plans and document outcomes.
• Provide accurate reporting and perform medical record reviews to determine medical necessity.
• Interpret health plans and authorize/co-ordinate care per plan provisions.

Skills

Clinical nursing

Patient assessment

Care coordination

Cross-functional collaboration

Education

Bachelor's degree in nursing

Graduate of accredited nursing program

Job description

GuideWell, Inc. is seeking an RN Case Manager in the Irving, TX area to design, implement and monitor treatment plans that meet patients’ healthcare goals. You will assess needs, coordinate interdisciplinary options, and navigate benefit structures to optimize care.

The role requires 5+ years nursing experience, a nursing degree, and an active RN license. You’ll collaborate across teams, manage cost-conscious care plans, and report outcomes to clients and stakeholders.