Remote RN Case Manager – Data-Driven Chronic Care Navigator

SmartRecruiters, Inc.; Davenport (IA); Remote; USD 81,000 - 99,000; Full time

Benefits offered by this job

Work from Home

Medical, Dental, Vision

401(k) with match

Life and Disability Insurance

Paid time off

Parental leave

Learning and development

Job summary

Guidehealth is a remote-first healthcare company seeking an experienced RN Case Manager with an Illinois license to join the Value Based Care Services team. The role focuses on improving member management, satisfaction, and cost effectiveness while guiding members through the healthcare system.

This full-time position involves telephonic outreach, data collection, clinical review, and documentation in compliance with federal/state regulations. Telework and dedicated patient care drive outcomes.

Qualifications

• Current IL Registered Nurse License is required.
• Minimum of five years of experience in varied healthcare settings.
• Strong case management and chronic condition management experience.
• Remote/telephonic work experience is preferred.
• Ability to navigate multiple EMR systems and use MS Office tools.

Responsibilities

• Pulling, sorting, and analyzing data to determine member eligibility in Population Health programs.
• Coordinate care that is timely, effective, equitable, safe, and member-centric.
• Manage case assignments, outreach, documentation, and case progression.
• Meet reporting and documentation standards with clients and staff.
• Educate members to navigate the HMO and healthcare system for cost-effective outcomes.
• Maintain HIPAA-compliant documentation and confidentiality.

Skills

RN Case Management

Telework / Remote Work

Clinical Judgment

MS Word / Excel

Interpersonal Communication

EMR Navigation

Education

IL Registered Nurse License

Tools

EMR systems

Job description

Guidehealth is a remote-first healthcare company seeking an experienced RN Case Manager with an Illinois license to join the Value Based Care Services team. The role focuses on improving member management, satisfaction, and cost effectiveness while guiding members through the healthcare system.

This full-time position involves telephonic outreach, data collection, clinical review, and documentation in compliance with federal/state regulations. Telework and dedicated patient care drive outcomes.