Role Description
The Nurse Case Manager serves as a customer advocate, partnering with members, families, and providers to coordinate care and support navigation of the healthcare system. This role focuses on whole-person health, behavior change, and delivering high-quality, customer-centered outcomes aligned with Care Solutions cultural beliefs.
-
Partner with customers to develop, implement, and document individualized care plans.
-
Use motivational interviewing, behavior change strategies, and shared decision-making to support health goals.
-
Coordinate care with providers, caregivers, and internal clinical partners to support whole-person health.
-
Engage customers through telephonic, digital, and written communication channels.
-
Track and document activities, outcomes, and progress in medical management systems.
-
Follow standard operating procedures and meet defined case management performance measures.
-
Maintain clinical expertise through required training and continuing education.
Qualifications
-
Active, unrestricted Registered Nurse (RN) license in a U.S. state or territory.
-
Minimum of two (2) years of full-time direct patient care experience as an RN.
-
Nursing degree from an accredited nursing program.
-
Ability to work an 8-hour shift between 9:00 a.m. and 9:00 p.m. EST, including evenings as business needs require.
-
Strong communication skills across telephonic and digital platforms.
-
Proficiency with Microsoft Word, Excel, Outlook, and clinical documentation systems.
Requirements
-
Case management certification (URAC-recognized) obtained within four (4) years of hire.
-
Experience working in remote, telephonic, or digital care management environments.
-
Strong organizational skills with the ability to manage multiple priorities in a fast-paced setting.
-
Demonstrated ability to work effectively with culturally diverse populations.
-
Flexibility to support non-standard shifts or occasional on-site meetings or audits.
-
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
Benefits
-
Annual salary of 77,500 - 129,100 USD / yearly, depending on relevant factors, including experience and geographic location.
-
Eligibility to participate in an annual bonus plan.
-
Comprehensive range of health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
-
401(k) plan.
-
Company paid life insurance.
-
Tuition reimbursement.
-
A minimum of 18 days of paid time off per year and paid holidays.