Remote RN Case Manager: Care Coordination Expert

WPS Health Solutions; Monona (WI); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Remote work

Bonus opportunities

401(k) match

Paid time off

Health insurance

Dental insurance

Telehealth

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-centered care plans, education for patients and families, and act as a liaison among members, families and providers.

Role supports remote work in approved states, with a strong focus on documenting care activities, managing caseloads, and ensuring high-quality, cost-efficient care across settings.

Qualifications

• RN with current WI licensure or compact license.
• 4+ years RN experience in varied settings.
• 2+ years case management experience.
• Familiarity with health plan operations and insurance benefits.
• Proficient with healthcare software and systems.

Responsibilities

• Coordinate care and services for case managed members.
• Review prior authorizations for high-cost services.
• Advocate for member needs and remove barriers to care.
• Coordinate transitions of care between settings.
• Document care management activities and outcomes.

Skills

RN licensure

Case management

Analytical skills

Communication skills

MS Office

Education

BSN preferred

Tools

EMR systems

Microsoft Office

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-centered care plans, education for patients and families, and act as a liaison among members, families and providers.

Role supports remote work in approved states, with a strong focus on documenting care activities, managing caseloads, and ensuring high-quality, cost-efficient care across settings.