RN Manager, Case Management Operations (Remote, Telephonic)

EXL Service; Baton Rouge (LA); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading data analytics company in Baton Rouge is seeking an RN Manager for Case Management Operations. The role involves leading a remote team of RN case managers and ensuring high-quality service delivery. The ideal candidate will have over 5 years of RN experience and at least 2 years in management. This position offers opportunities for professional growth and a dynamic working environment.

Benefits

Mentoring programs

Opportunities for growth

Innovative work environment

Qualifications

• Active RN license in state of residence with multi-state privileges required.
• More than 5 years RN experience with direct patient care responsibilities.
• At least 2 years managing a clinical team is required.

Responsibilities

• Monitor daily team activities and serve as a resource for staff.
• Conduct coaching and mentoring for team members.
• Coordinate staffing and workload management for the team.

Skills

RN case management operations

Team management

Communication skills

Process improvement

Education

Bachelor’s degree in nursing

Tools

Microsoft Office

Job description

Company Overview and Culture

EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes, and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media, and retail, among others. Founded in 1999, our core values are innovation, collaboration, excellence, integrity, and respect. Headquartered in New York, we have more than 55,000 employees across six continents. For more information, visit http://www.exlservice.com.

About EXL Health

We leverage human ingenuity and domain expertise to help clients improve outcomes, optimize revenue, and maximize profitability across the healthcare ecosystem. Technology, data, and analytics are central to our solutions. We work closely with clients to transform how care is delivered, managed, and paid.

EXL Health combines deep domain expertise with analytic insights and technology-enabled services to transform healthcare delivery, management, and payment. Using human ingenuity, we collaborate with clients to solve complex problems and enhance performance with scalable solutions. With data on over 260 million lives, we serve hundreds of organizations across the healthcare ecosystem.

We assist payers in improving member care quality and network performance, managing population risk, and reducing administrative waste and health claim expenditures. We support Pharmacy Benefit Managers (PBMs) in managing drug benefits and reducing costs while maintaining quality. We help provider organizations proactively manage risk, improve outcomes, and optimize network performance. Additionally, we provide Life Sciences companies with enriched data, insights through advanced analytics, and data visualization tools to ensure appropriate treatment at the right time.

Registered Nurse Manager, Case Management Operations

As the RN Manager, Case Management Operations, you will foster a culture of collaboration, adaptability, and accountability by guiding daily operations, championing process improvements, and ensuring team members are equipped through training, feedback, and professional growth opportunities. You will lead a remote team of telephonic, complex care RN case managers to deliver high-quality service to Tricare beneficiaries.

Work Schedule: Monday - Friday, 8-hour shifts with rotating times starting at 8 am or 11 am, 2 or 3 days per week.

Responsibilities:

• Monitor daily team activities and serve as a resource for staff queries.
• Coordinate and facilitate staff meetings, department meetings, and case rounds with medical directors.
• Provide confidential coaching and feedback to staff regarding quality audits and performance improvement.
• Assist with interview and hiring processes; collaborate on new hire orientation and ongoing training.
• Conduct coaching, mentoring, disciplinary actions, and document interventions.
• Maintain knowledge of beneficiary benefits, policies, standards, and community resources to ensure optimal outcomes.
• Support team in conducting case management activities within licensure scope.
• Identify and escalate potential risk management issues.
• Seek process improvement opportunities for effective case management.
• Investigate grievances and support resolution processes.
• Coordinate staffing, workloads, and time off for team members.
• Assess staffing needs and recommend adjustments to leadership.
• Participate in projects, committees, and engagement initiatives.
• Maintain required CEUs and licenses, obtaining additional licenses as needed.
• Collaborate with other managers to ensure program delivery.

Qualifications:

Required:

• Must be a U.S. citizen.
• Ability to obtain Security Clearance; current DOD Security Clearance preferred.
• Active RN license in state of residence with multi-state privileges (compact license).
• At least 2 years managing a clinical team.
• Over 5 years RN experience with direct patient care responsibilities.
• Bachelor’s degree in nursing from an accredited institution.
• Experience in RN case management operations and managing remote RN teams.
• Proficient in Microsoft Office and mobile technologies.

Preferred:

• Case Management Certification (CCM preferred).
• Experience managing telephonic RN case management for health plans.
• Participation in performance and quality improvement projects.
• Experience in NCQA-accredited case management programs.
• Ability to handle multiple demands remotely professionally.
• Strong communication skills and team-building focus.
• Knowledge of payor issues, benefits, and case management initiatives.

What We Offer:

• An innovative, fast-paced environment with experienced healthcare professionals.
• Opportunities to learn across various aspects of client businesses.
• Mentoring programs with guidance from senior professionals.
• Room for growth and development within the company and beyond.

EEO/Minorities/Females/Vets/Disabilities

To view our total rewards, click here: https://www.exlservice.com/us-careers-and-benefits

Base Salary Range Disclaimer: The listed salary range is indicative; actual salaries depend on location and experience. It is part of the total compensation, which may include bonuses, PTO, and region-specific benefits. Data shared will be processed per our Privacy Policy.

Application & Interview Impersonation Warning: Impersonating individuals during application or interviews is illegal and can lead to rejection, rescinded offers, termination, or legal action. We may use AI in our recruitment process; candidates can opt out without impact on their application.