Remote RN Case Manager: Care Coordination & Outcomes

WebTPA; Irving (TX); Remote; USD 70,000 - 110,000; Full time

Job summary

WebTPA, a GuideWell Company, is seeking a Registered Nurse Case Manager in Irving, TX to create, implement, and monitor treatment plans helping members meet healthcare goals. You will assess health status, coordinate care with providers and families, and develop cost-effective, high-quality plans aligned with member benefits.

The role requires 5+ years in clinical nursing and strong collaboration across teams.

Qualifications

• 5+ years in clinical nursing and patient assessment.
• Bachelor’s degree or equivalent work experience.
• Graduate of an accredited school of nursing.
• RN state licensure.
• Knowledge of medical terminology, treatment planning, quality care and cost containment.
• Ability to collaborate across operations.

Responsibilities

• Case management assesses health status and care needs, including discharge planning.
• Coordinate contact with patient, family, physicians, and community resources.
• Identify alternative treatment plans approved by all parties.
• Monitor care plans based on changing client needs.
• Identify services and providers to serve members timely and cost-effectively.
• Develop and implement short and long-term case management goals.
• Use technology to evaluate cost-effectiveness of treatment plans.
• Provide accurate reporting to clients.
• Review medical records to determine medical necessity.
• Interpret health plans and authorize/co-ordinate care.

Skills

Nursing experience

Care coordination

Clinical assessment

Medical terminology

Collaboration

Cost containment

Education

Bachelor’s degree or related equivalent

Graduate of accredited nursing school

Job description

WebTPA, a GuideWell Company, is seeking a Registered Nurse Case Manager in Irving, TX to create, implement, and monitor treatment plans helping members meet healthcare goals. You will assess health status, coordinate care with providers and families, and develop cost-effective, high-quality plans aligned with member benefits.

The role requires 5+ years in clinical nursing and strong collaboration across teams.