RN Manager, Case Management Operations (Remote, Telephonic)

EXL Service; Bozeman (MT); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading data analytics company is seeking a Registered Nurse Manager for Case Management Operations. The role involves overseeing daily operations, leading a team of telephonic RN case managers, and ensuring quality service delivery. The ideal candidate will have significant clinical experience, management capabilities, and strong communication skills. This position offers opportunities for professional growth and development.

Benefits

Dynamic and innovative environment

Mentoring programs

Professional growth opportunities

Potential career advancement

Qualifications

• U.S. citizenship required.
• Unrestricted RN license with multi-state privileges.
• Minimum 2 years managing a clinical team.
• 5 years RN experience in clinical setting.
• Experience in RN case management operations.

Responsibilities

• Monitor daily team activities.
• Coordinate staff meetings and department communications.
• Provide coaching on performance improvements.
• Conduct performance evaluations.
• Collaborate with other managers to deliver programs.

Skills

Leadership

Communication

Case Management

Adaptability

Process Improvement

Education

Bachelor’s degree in nursing from an accredited institution

Tools

Microsoft Office

Mobile technologies

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 over 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 revolutionize care delivery, management, and payment. Using human ingenuity, we collaborate with clients to solve complex problems and enhance performance with scalable solutions. With data on more than 260 million lives, we serve hundreds of organizations across the healthcare sector.

We assist payers in improving member care quality and network performance, managing population risk, and reducing administrative waste and health claim costs. We support Pharmacy Benefit Managers (PBMs) in managing drug benefits and reducing spending 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, and visualization tools to deliver the right treatment to the right patient 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 overseeing daily operations, championing process improvements, and ensuring team members are equipped through training, feedback, and professional development. 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 start times at 8 am and 11 am, 2 or 3 days per week.

Responsibilities:

• Monitor daily team activities and serve as a resource for staff.
• Coordinate and facilitate staff meetings, department meetings, and case rounds with medical directors.
• Provide coaching and feedback on quality audits and performance improvement.
• Assist with recruitment, onboarding, training, mentoring, and disciplinary actions.
• Conduct performance evaluations and document staff performance.
• Maintain knowledge of beneficiary benefits, policies, standards, and community resources.
• Ensure case management activities align with licensure scope.
• Identify and escalate risk management issues.
• Identify process improvements for case management services.
• Investigate grievances and support resolution.
• Coordinate staffing and workload management.
• Participate in projects, committees, and engagement initiatives.
• Maintain required CEUs and licenses.
• Collaborate with other managers to deliver programs effectively.

Qualifications:

Required:

• U.S. citizenship.
• Ability to obtain security clearance; DOD clearance preferred.
• Unrestricted RN license in state of residence with multi-state privileges.
• Minimum 2 years managing a clinical team.
• At least 5 years RN experience in a clinical setting 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.
• Proficiency in Microsoft Office and mobile technologies.

Preferred:

• Case Management Certification (CCM preferred).
• Experience as a telephonic RN case manager.
• Participation in performance or quality improvement projects.
• Experience in NCQA-accredited programs.
• Ability to manage multiple demands remotely.
• Strong communication and interpersonal skills.
• Commitment to team development and a positive work environment.
• Knowledge of payor issues, benefits, and case management initiatives.

What We Offer:

• Dynamic and innovative environment with experienced professionals.
• Opportunities for learning and professional growth.
• Mentoring programs and development opportunities.
• Potential for further career advancement within the company.

EEO/Minorities/Females/Vets/Disabilities

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

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We may use AI to assist in screening, but final hiring decisions are made by our team, who consider the full profile. Candidates may opt out of AI screening without impact on their application.