Remote RN Case Manager | Care Coordination Pro

MedWatch; United States; Remote; USD 72,000 - 81,000; Full time

Benefits offered by this job

Bonus program

Job summary

MedWatch is seeking a Remote Registered Nurse Case Manager to handle an individual caseload using standard case management processes. You will authorize services, review treatment plans for medical necessity, and maintain ongoing communication with the health care team from a home office.

Requirements include an active RN license in the United States, a health-related bachelor’s degree preferred, and about 7 years of clinical experience.

Qualifications

• RN with current active license in the United States or territories.
• Bachelor’s degree in a health-related field preferred.
• 7 years of varied clinical experience preferred.
• URAC‑recognized certification in Case Management within 3 years of hire.

Responsibilities

• Practice within the scope of licensure.
• Review medical data to establish and maintain case management plans.
• Assess problems and set goals with actions to meet patient needs.
• Contact payer offices to understand benefit constraints.
• Coordinate with providers and equipment vendors to verify medical necessity.
• Manage case management files and prepare timely reports to payers.
• Maintain billing in the computer system and stay connected with care teams.
• Negotiate with providers to maximize benefits and direct to appropriate resources.
• Adhere to company policies and participate in Quality Management.
• Be aware of non-medical issues affecting safety or welfare and consult supervisor as needed.
• Maintain URAC‑recognized certification within 3 years.

Skills

Case management

Communication

Medical terminology

Attention to detail

Education

RN

Bachelor’s degree in a health-related field preferred

URAC‑recognized Case Management certification within 3 years

Job description

MedWatch is seeking a Remote Registered Nurse Case Manager to handle an individual caseload using standard case management processes. You will authorize services, review treatment plans for medical necessity, and maintain ongoing communication with the health care team from a home office.

Requirements include an active RN license in the United States, a health-related bachelor’s degree preferred, and about 7 years of clinical experience.