Remote RN Case Manager: Care Coordination & Outcomes

MedWatch, LLC; Florida; Remote; USD 72,000 - 81,000; Full time

Benefits offered by this job

Bonus program

Job summary

MedWatch, LLC is seeking a Registered Nurse Case Manager to handle an individual caseload from a home-based setting. You will authorize services, review treatment plans for medical necessity, and maintain ongoing communication with the health care team.

The role emphasizes case management, documentation, and payer coordination to ensure quality patient care. Required are an active RN license and a bachelor’s degree in a health-related field preferred, with 7 years of clinical experience

Qualifications

• Active RN license in the state of practice and residence.
• Bachelor's degree in a health-related field preferred.
• 7 years of varied clinical experience preferred.

Responsibilities

• The Registered Nurse Case Manager will practice within the scope of licensure.
• Review medical data to establish and maintain a case management plan with providers, payers, patient, and caregiver.
• Assess problems, set goals, and document actions toward patient needs and care outcomes.
• Contact payer offices to understand benefit constraints affecting the plan of action.
• Coordinate with care providers and vendors to verify medical necessity of care or equipment.
• Maintain case files and prepare reports detailing actions and results for payers.
• Negotiate with providers to maximize patient benefits and arrange network referrals.
• Adhere to company policies and participate in the Quality Management Program.

Skills

RN license

Home care experience

Education

RN degree

BSN preferred

Job description

MedWatch, LLC is seeking a Registered Nurse Case Manager to handle an individual caseload from a home-based setting. You will authorize services, review treatment plans for medical necessity, and maintain ongoing communication with the health care team.

The role emphasizes case management, documentation, and payer coordination to ensure quality patient care. Required are an active RN license and a bachelor’s degree in a health-related field preferred, with 7 years of clinical experience