RN Case Manager

Decypher; Bethesda (MD); On-site; USD 55,000 - 83,000; Full time

Benefits offered by this job

Health benefits

Professional development

Weekday schedule on-site

Job summary

Decypher is seeking a dedicated RN Case Manager to support service members, veterans, and families. The role coordinates care, advocates for patients, and collaborates with multidisciplinary teams to ensure timely, high-quality, and cost-effective outcomes.

This on-site, full-time position emphasizes documentation accuracy, regulatory compliance, and care planning for active-duty personnel, retirees, and dependents.

Qualifications

• Associate Degree in Nursing from an NLNAC or CCNE accredited program (higher degrees accepted and encouraged).
• Current, full, active, and unrestricted RN license.
• BLS certification required.
• Certifications: CCM, CDMS, CRRN, COHN, COHN-S, ACCC, CRC, RN-NCM, or CMC preferred.
• Experience in Referral Management/Utilization Management (RM/UM) preferred.
• 2–5 years clinical experience in a behavioral health subspecialty.
• Experience assessing adult and geriatric patients.
• Experience coordinating care as part of a multidisciplinary healthcare team.
• Knowledge of EMR systems and databases such as ESSENTRIS and CHCS.
• U.S. Citizenship is required.

Responsibilities

• Coordinate patient care across the healthcare continuum to ensure timely and effective delivery of services.
• Serve as a patient advocate, addressing needs, removing barriers, and supporting families as they navigate the healthcare system.
• Manage complex and high-risk cases, including behavioral health, traumatic injury, chronic illness, or end-of-life care.
• Develop and implement individualized care plans that target quality improvement and improved patient outcomes.
• Facilitate referrals, appointments, and follow-up care in collaboration with multidisciplinary teams.
• Support active-duty service members, veterans, and their families through case and utilization management expertise.
• Promote patient-centered, cost-effective care while identifying opportunities for process and quality improvement.
• Educate patients and families on available resources, self-care practices, and navigation of healthcare systems.
• Maintain accurate and thorough clinical documentation using electronic medical records and healthcare databases.
• Collaborate with healthcare professionals and leadership, providing consultation and education as needed.
• Ensure compliance with nursing standards, policies, and accreditation guidelines, consistently striving for clinical excellence.

Skills

Clinical assessment

Care coordination

Communication

Advocacy

Team collaboration

EHR proficiency

Education

Associate Degree in Nursing (NLNAC/CCNE)

Tools

ESSENTRIS

CHCS

Job description

Decypher is seeking a dedicated and experienced RN Case Manager to join our team and make a positive difference in the lives of service members, veterans, and their families. Since 2008, Decypher has been a leading provider of healthcare services, technology, and management solutions, partnering with the Defense Health Agency to support the health and readiness of those who serve our nation. As an RN Case Manager, you will be instrumental in delivering comprehensive case management and utilization management services that promote quality, patient-centered care and cost-effective outcomes.

In this full-time RN Case Manager position, you will coordinate patient care across the healthcare continuum, acting as a trusted advocate for patients and their families. You will manage complex and high-risk cases, develop individualized care plans, and collaborate with multidisciplinary teams to ensure optimal access to healthcare resources. Your expertise will be valued in supporting active-duty service members, retirees, and their dependents, ensuring they receive the highest standard of care throughout their healthcare journey.

The RN Case Manager role requires a commitment to excellence, strong clinical skills, and the ability to navigate the complexities of the healthcare system. You will be responsible for maintaining accurate documentation, adhering to regulatory and accreditation standards, and continuously seeking opportunities for quality improvement in patient care delivery. This is an excellent opportunity for a motivated RN with case management experience to join a mission-driven organization and make a meaningful impact.

Working in this RN Case Manager position offers the chance to be part of a collaborative and supportive environment, where your contributions help ensure the health and well-being of those who have served.

RN Case Manager - Summary

• RN Case Manager responsible for comprehensive case and utilization management within a multidisciplinary healthcare environment.
• Supports military service members, veterans, retirees, and their families by coordinating patient care and advocating for their health needs.
• Works closely with healthcare providers and administrative staff to deliver high-quality, cost-effective care.
• Contributes to the mission of improving health outcomes and access to care for the military community.

Duties & Responsibilities

• Coordinate patient care across the healthcare continuum to ensure timely and effective delivery of services.
• Serve as a patient advocate, addressing needs, removing barriers, and supporting families as they navigate the healthcare system.
• Manage complex and high-risk cases, including those involving behavioral health, traumatic injury, chronic illness, or end-of-life care.
• Develop and implement individualized care plans that target quality improvement and improved patient outcomes.
• Facilitate referrals, appointments, and follow-up care in collaboration with multidisciplinary teams.
• Support active-duty service members, veterans, and their families through case and utilization management expertise.
• Promote patient-centered, cost-effective care while identifying opportunities for process and quality improvement.
• Educate patients and families on available resources, self-care practices, and navigation of healthcare systems.
• Maintain accurate and thorough clinical documentation using electronic medical records and healthcare databases.
• Collaborate with healthcare professionals and leadership, providing consultation and education as needed.
• Ensure compliance with nursing standards, policies, and accreditation guidelines, consistently striving for clinical excellence.

Salary & Benefits

• Competitive hourly compensation commensurate with experience and qualifications.
• Comprehensive benefits package including health and wellness options.
• Opportunities for professional development and career advancement within a supportive organization.
• Work-life balance with a regular weekday schedule on site.

Qualifications & Requirements

• Associate Degree in Nursing from an NLNAC or CCNE accredited program (higher degrees accepted and encouraged).
• Current, full, active, and unrestricted license to practice as a Registered Nurse (RN).
• Basic Life Support (BLS) certification required.
• At least one of the following certifications: CCM, CDMS, CRRN, COHN, COHN-S, ACCC, CRC, RN-NCM, or CMC.
• Experience in Referral Management/Utilization Management (RM/UM) preferred.
• Two to five years of clinical experience in a behavioral health subspecialty.
• Experience assessing adult and geriatric patients as appropriate.
• Experience coordinating care as part of a multidisciplinary healthcare team.
• Knowledge of electronic medical records systems and healthcare databases such as ESSENTRIS and CHCS.
• U.S. Citizenship is required.

Ideal Candidate Snapshot

• A compassionate RN Case Manager with strong clinical assessment and care coordination skills.
• Demonstrated expertise in managing complex or high-risk patient cases.
• Effective communicator and advocate for patients and their families.
• Comfortable working with electronic health records and healthcare data systems.
• Team-oriented, collaborative, and committed to continuous improvement and professional growth.
• Dedicated to supporting the health of military communities and upholding organizational values.

Other Relevant Information

• Physical requirements include the ability to sit, stand, walk, bend, reach, and move throughout the medical facility as needed.
• Ability to use computers and electronic medical records for extended periods.
• Must be able to safely assist with patient care, equipment, and supplies as required.
• Additional role specifics and expectations will be discussed during the interview process.
• Decypher is an equal opportunity and affirmative action employer committed to a diverse and inclusive workforce (M/F/D/V).