Remote RN Case Manager | Managed Care & Coordination

CEI; Columbia, Northern (SC, KY); Hybrid; USD 34,000 - 47,000; Full time

Job summary

CEI is seeking a Medical Case Management Nurse to join the team. The role requires residing within 2 hours of Columbia, SC and willingness to train on site for the first week.

You will conduct active case management, assess needs, coordinate action plans, and monitor services to ensure medical necessity and beneficial outcomes for members. The position offers $30/hour with optional benefits and requires an active SC RN license and at least 4 years of clinical nursing experience.

Qualifications

• Must have active unrestricted RN license in the State of South Carolina.
• Minimum 4 years of recent clinical nursing experience.
• Must live within 2 hours of Columbia, SC and be willing to train on site for the first week.

Responsibilities

• Provides active case management and coordinates action plans with members.
• Evaluates outcomes and medical necessity for services.
• Documents clinical information to support benefits and contract terms.
• Provides telephonic support for members with chronic conditions and high-risk pregnancies.
• Performs review/authorization and ensures coverage within guidelines.
• Interacts with Medical Director, Case Manager and other staff as needed.
• Promotes enrollment in care and member advocacy.

Skills

Case management

Telephonic support

Clinical nursing

Education

Active RN license in SC

Job description

CEI is seeking a Medical Case Management Nurse to join the team. The role requires residing within 2 hours of Columbia, SC and willingness to train on site for the first week.

You will conduct active case management, assess needs, coordinate action plans, and monitor services to ensure medical necessity and beneficial outcomes for members. The position offers $30/hour with optional benefits and requires an active SC RN license and at least 4 years of clinical nursing experience.