RN Care Management Coordinator

IntePros; Pennsylvania; Remote; USD 60,000 - 80,000; Full time

Job summary

IntePros is seeking a qualified RN Care Management Coordinator for a fully remote role supporting a healthcare insurance client. The position requires an active PA RN license and involves reviewing medical records, assessing treatment plans, and collaborating with internal teams. Ideal candidates will have strong communication skills and experience in behavioral health.

Qualifications

• Active PA RN license required, or LSW, LCSW, LPC, LMFT.
• Minimum 3 years in behavioral health clinical roles.

Responsibilities

• Review medical records to determine medical necessity of services.
• Communicate with providers to clarify treatment details.

Skills

Interpersonal Skills

Problem-Solving

Communication

Organizational Skills

Education

BSN

Tools

Microsoft Office

SharePoint

Job description

Get AI-powered advice on this job and more exclusive features.

This range is provided by IntePros. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$40.00/hr - $45.00/hr

Direct message the job poster from IntePros

Information Technology Recruiter at IntePros

IntePros is currently seeking a qualified RN Care Management Coordinator to support our healthcare insurance client. This fully remote opportunity requires candidates to hold an active PA RN license and reside in the tri-state area (PA, NJ, or DE).

Location: Fully Remote (Tri-State Area: PA, NJ, DE)

Licensure Required: Active RN (PA), or LSW, LCSW, LPC, or LMFT

Job Summary:

The Behavioral Health Care Management Coordinator reviews medical records and behavioral health documentation to determine the medical necessity of services. Using clinical knowledge and established criteria such as InterQual and ASAM, this role supports utilization management and care coordination. The Coordinator may communicate with providers to obtain additional information and is authorized to approve care plans independently. Denials are escalated to a Medical Director for further review.

Key Responsibilities:

• Apply clinical judgment and critical thinking to evaluate cases using InterQual, ASAM, and other guidelines.
• Assess behavioral health treatment plans for medical necessity, length of stay, and appropriateness of services.
• Communicate with providers to clarify behavioral health treatment details and determine medical need.
• Collaborate with internal teams on discharge planning and care settings.
• Escalate high-risk cases to Medical Directors or Quality Management as needed.
• Ensure compliance with all regulations.
• Document activities accurately per policies and timelines.
• Meet turnaround times and productivity goals for authorizations.

Qualifications:

• Licensure: Active PA RN license (required), or LSW, LCSW, LPC, LMFT.
• Education: BSN preferred for RNs.
• Experience:
• Minimum 3 years in behavioral health clinical roles.
• Experience in utilization management preferred.
• Experience in medical management/precertification is a plus.

Skills and Competencies:

• Strong interpersonal, problem-solving, and communication skills.
• Ability to manage multiple priorities remotely.
• Proficient in Microsoft Office and SharePoint.
• Adaptable to new technologies.
• Strong organizational skills.
• Team-oriented with a focus on diversity and patient advocacy.

Seniority level

• Associate

Employment type

• Contract

Job function

• Health Care Provider, Administrative, and Other

Industries

• IT Services and Consulting, Hospitals and Healthcare, Insurance

Referrals increase your chances of interviewing at IntePros by 2x

Set job alerts for “Registered Nurse” roles.

Related jobs include:

• RN - Clinical Documentation Nurse (Local/Remote)
• RN - Clinical Documentation Improvement Specialist Senior (CCDS Certification Required)
• RN - Best Practice Clinical Consultant
• RN - Senior Clinical Documentation Improvement Specialist (CCDS Certification required)
• RN Care Coordinator - ECCM (RN) York County and Lancaster County, PA
• Registered Nurse (RN) Weekday On-Call - Senior LIFE Indiana
• RN - Tele/Med Surg - IST (AHN Travel Team)
• Registered Nurse - RN / Step Down Unit - TELE-P
• Senior Product Manager, Nursing Education Solutions (Remote)