Remote RN Case Manager — Wellness & Care Coordination

hireops; Aurora (IL); Remote; USD 75,000 - 105,000; Full time

Job summary

hireops is seeking a qualified professional to manage medical programs for government health care members. The role involves educating customers, analyzing data for regulatory reports, and representing the company to members.

The candidate must hold a relevant license and have field-visit travel readiness. Responsibilities include working remotely with occasional field visits across territories, leveraging clinical knowledge and data analysis to support health outcomes and compliance.

Qualifications

• Verbal and written communication skills including discussing medical needs with members and interfacing with internal staff/management and external vendors and community resources.
• Analytical experience including medical data analysis.
• Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, obtain active, unrestricted RN licensure within 90 days of hire.
• 3 years wellness or managed care experience presenting clinical issues with members/physicians.

Responsibilities

• The position conducts medical management and health education programs for customers on government health care programs.
• Accountabilities include gathering, analyzing and providing data for regulatory reports.
• Represents the company to members.

Skills

Verbal and written communication

Analytical reasoning

PC proficiency

Education

RN license

LPC license

LMSW license

Tools

Microsoft Office

Database experience

Web-based applications

Job description

hireops is seeking a qualified professional to manage medical programs for government health care members. The role involves educating customers, analyzing data for regulatory reports, and representing the company to members.

The candidate must hold a relevant license and have field-visit travel readiness. Responsibilities include working remotely with occasional field visits across territories, leveraging clinical knowledge and data analysis to support health outcomes and compliance.