RN Case Manager - Care Coordination & Quality Improvement

Mercy Health Corporation; Janesville (WI); On-site; USD 64,000 - 97,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Life & Disability Insurance

FSA/HSA Options

Paid time off

Job summary

Mercyhealth is seeking an experienced Registered Nurse Case Manager to coordinate individualized care plans and ensure compliance with NCQA, HEDIS, and quality standards. This full-time, day-shift role requires strong care coordination and a commitment to improving member outcomes.

The ideal candidate will have a nursing degree, RN licensure, and experience in case management and quality improvement initiatives within a health plan environment.

Qualifications

• Graduate of an accredited nursing program; BSN completion required or enrollment in BSN Completion Program.
• RN license in state of practice; CCM certification preferred or in process.

Responsibilities

• Provide direct case management activities at least 60% of time.
• Collects detailed information to develop comprehensive case management plans.
• Assess benefits/coverage based on Mercyhealth policies and medical necessity.

Skills

Case management

Care coordination

HEDIS knowledge

Quality improvement

Team collaboration

Education

BSN

Job description

Mercyhealth is seeking an experienced Registered Nurse Case Manager to coordinate individualized care plans and ensure compliance with NCQA, HEDIS, and quality standards. This full-time, day-shift role requires strong care coordination and a commitment to improving member outcomes.

The ideal candidate will have a nursing degree, RN licensure, and experience in case management and quality improvement initiatives within a health plan environment.