Remote RN Case Manager – Government Programs

Moda Health; Portland (OR); Remote; USD 72,000 - 90,000; Full time

Benefits offered by this job

Medical benefits

401K matching

FSA

Employee assistance program

PTO and holidays

Job summary

Moda Health is seeking a Registered Nurse Case Manager to perform comprehensive case management within Government Programs. This full-time, work-from-home role focuses on coordinating care for members, collaborating with providers, and ensuring timely treatment plans—all while maintaining compliance with medical policies and standards.

Ideal candidates hold an Oregon RN license, CCMC certification or willingness to obtain, and at least 3 years of relevant hospital or home health experience.

Qualifications

• Must have an accredited nursing degree and an active Oregon RN license.
• CCMC certification required or obtainable within 24 months of hire.
• Minimum 3 years of recent hospital, home health, or acute care experience.
• Proficiency with Microsoft Office; strong analytical and problem-solving skills.
• Excellent verbal and written communication; able to work under pressure.

Responsibilities

• Manage essential activities of case management including assessment, planning, implementation, coordination, monitoring and evaluation.
• Coordinate member care plans with providers to ensure timely, appropriate care.
• Apply clinical judgment to ensure compliance with medical policy and standards of care.
• Maintain timely, accurate documentation and communicate with members and providers.
• Collaborate with other departments to resolve claims, quality of care, and provider issues.

Skills

RN license

Case management

Documentation

Communication

Time management

Education

Nursing degree

Tools

Electronic Health Records (EHR)

Job description

Moda Health is seeking a Registered Nurse Case Manager to perform comprehensive case management within Government Programs. This full-time, work-from-home role focuses on coordinating care for members, collaborating with providers, and ensuring timely treatment plans—all while maintaining compliance with medical policies and standards.

Ideal candidates hold an Oregon RN license, CCMC certification or willingness to obtain, and at least 3 years of relevant hospital or home health experience.