Remote RN Case Manager - Care Coordination & Outcomes

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

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Travel health insurance

Disability insurance

Leave programs

Retirement plan

Paid time off

Volunteer time off

Holidays

Wellness program

Job summary

WebTPA, a GuideWell Company, is a healthcare third-party administrator seeking an RN Case Manager to create, implement, and monitor treatment plans for members. The role focuses on assessing needs, coordinating care, and optimizing benefits in alignment with plan provisions.

Hours are Monday to Friday, 8am–5pm Central Time. The role requires 5+ years nursing experience, a valid RN license, and strong collaboration across disciplines to ensure high-quality, cost-conscious patient care.

Qualifications

• 5+ years related work experience with a professional background in clinical nursing and patient assessment.
• 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 discharge planning and outpatient management.
• Contact with patient, family, physicians, and care providers; liaise with employer/client as needed.
• Identify and propose alternative care plans approved by all parties.
• Monitor health status and adjust care plans to evolving needs.
• Identify services and providers to promote value and cost-effectiveness.
• Develop and implement short- and long-term Case Management goals with documented plans.
• Use resources to evaluate cost-effectiveness of treatment plans pre- and post-implementation.
• Provide accurate and timely reporting to clients and stakeholders.
• Review medical records to determine medical necessity of services.
• Coordinate care by interpreting health plans and authorizing services.

Skills

Clinical nursing

RN license

Care assessment

Interdisciplinary care

Medical terminology

Collaboration

Education

Bachelor's degree

Nursing degree

Job description

WebTPA, a GuideWell Company, is a healthcare third-party administrator seeking an RN Case Manager to create, implement, and monitor treatment plans for members. The role focuses on assessing needs, coordinating care, and optimizing benefits in alignment with plan provisions.

Hours are Monday to Friday, 8am–5pm Central Time. The role requires 5+ years nursing experience, a valid RN license, and strong collaboration across disciplines to ensure high-quality, cost-conscious patient care.