Remote RN Case Manager — Care Coordination & Outcomes

WebTPA; United States; Hybrid; USD 85,000 - 105,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

Life insurance

Short- and long-term disability

Retirement Savings Plan with employer

Paid time off and holidays

Wellness program

Job summary

WebTPA, a GuideWell Company, is seeking an experienced RN Case Manager in the United States (Irving, TX, remote) to create, implement, and monitor treatment plans for members. The role requires nursing licensure, a related Bachelor's degree, and strong collaboration across disciplines to meet healthcare goals.

You will assess health status, coordinate with patients and providers, coordinate cost-effective care, document outcomes, and continually adjust plans to reflect patient needs and plan

Qualifications

• Bachelor's degree in Nursing or related field required.
• RN licensure required in state of practice.
• Graduate of an accredited school of nursing.
• Knowledgeable in medical terminology 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.
• Coordinate with patients, families, physicians and providers and employer/client as needed.
• Identify alternative treatment plans approved by all parties. Base on quality care within cost constraints.
• Monitor health status and adjust care plans as needed.
• Identify services, resources and facilities to serve members timely and cost-effectively.
• Develop and implement short and long-term Case Management goals with care plans.
• Evaluate cost-effectiveness of treatment plans and report outcomes.
• Perform medical record review to determine medical necessity.
• Interpret health plans and authorize/co-ordinate care per plan provisions.

Skills

Clinical nursing

Patient assessment

Collaboration

Education

Bachelor's degree in Nursing or related field

RN licensure

Graduate of accredited nursing school

Job description

WebTPA, a GuideWell Company, is seeking an experienced RN Case Manager in the United States (Irving, TX, remote) to create, implement, and monitor treatment plans for members. The role requires nursing licensure, a related Bachelor's degree, and strong collaboration across disciplines to meet healthcare goals.

You will assess health status, coordinate with patients and providers, coordinate cost-effective care, document outcomes, and continually adjust plans to reflect patient needs and plan