Remote RN Case Manager: Patient Care Navigator

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

Benefits offered by this job

Bonus program

Job summary

MedWatch is seeking a Registered Nurse Case Manager for a remote, work-from-home role in the United States. You will manage an individual caseload, authorize services, review treatment plans for medical necessity, and coordinate with providers, payers, and the patient’s care team.

Responsibilities include maintaining case management files, documenting actions, and ensuring quality patient care within licensure.

Qualifications

• RN with current, unrestricted license in the United States or its territories.
• Bachelor’s degree in a health-related field preferred.
• At least 7 years of varied clinical experience preferred.

Responsibilities

• Review medical data to establish and maintain a case management plan with providers, payers, patient and caregiver.
• Contact the payer to understand benefit constraints affecting the plan of action.
• Coordinate with care providers and equipment vendors to verify medical necessity of care or equipment.
• Maintain case management files, document actions, and prepare reports to payers detailing progress.
• Ensure quality patient care within licensure and company policies; adhere to the scope of practice.
• Pursue URAC-recognized certification within 3 years and participate in Quality Management.

Skills

Case management

Clinical nursing

Communication

Education

RN license (US)

Bachelor's degree in health-related field

Job description

MedWatch is seeking a Registered Nurse Case Manager for a remote, work-from-home role in the United States. You will manage an individual caseload, authorize services, review treatment plans for medical necessity, and coordinate with providers, payers, and the patient’s care team.

Responsibilities include maintaining case management files, documenting actions, and ensuring quality patient care within licensure.