RN Behavioral Health Case Manager - Care Coordination

Brighton Health Plan Solutions; United States; Remote; USD 75,000 - 110,000; Full time

Job summary

Brighton Health Plan Solutions is seeking a dedicated registered nurse for a Case Management role. You will conduct comprehensive assessments, develop member-centered care plans, and coordinate across care settings with an interdisciplinary team to improve outcomes and ensure compliant documentation.

This role emphasizes behavioral health integration, care transitions, and ongoing evaluation of progress toward goals within the NCQA framework.

Qualifications

• Current, active, unrestricted Registered Nurse (RN) license.
• Compact (Multistate) Nursing Licensure is required; NY licensure preferred and may need to be obtained within 30 days.
• BSN preferred; ADN with relevant experience considered.
• Minimum 2 years of nursing experience in case management or related clinical settings; behavioral health experience preferred.
• Experience in behavioral health case management, integrated care, or coordination of services preferred.
• Knowledge of NCQA Care Management standards and regulatory requirements.

Responsibilities

• Conduct comprehensive assessments to identify medical, behavioral health, psychosocial, and care coordination needs.
• Develop, implement, and monitor individualized, member-centered care plans with interdisciplinary teams.
• Coordinate care across the healthcare continuum to promote quality outcomes and cost-effective care.
• Provide education and coaching to members and caregivers regarding health conditions and self-management.
• Identify gaps in care and opportunities to improve member outcomes and reduce avoidable utilization.
• Maintain documentation per HIPAA, NCQA, and regulatory standards.
• Collaborate with Utilization Management, Population Health, Behavioral Health, and Medical Directors.

Skills

RN License

Care Management

Behavioral Health

Interdisciplinary Teamwork

Communication Skills

Education

BSN Preferred

ADN with Experience Considered

CCM/ACM Certification Preferred

Tools

EMR Systems

Case Management Software

MS Office

Job description

Brighton Health Plan Solutions is seeking a dedicated registered nurse for a Case Management role. You will conduct comprehensive assessments, develop member-centered care plans, and coordinate across care settings with an interdisciplinary team to improve outcomes and ensure compliant documentation.

This role emphasizes behavioral health integration, care transitions, and ongoing evaluation of progress toward goals within the NCQA framework.