Job Description
Position: RN Case Manager
We are a data-powered, performance-driven healthcare organization dedicated to achieving operational excellence. Our mission is to make healthcare affordable, improve patient health, and restore the fulfillment of practicing medicine for providers. With a focus on empathy and powered by AI and predictive analytics, we connect patients and providers through our unique approach, building stronger relationships for better healthcare outcomes.
As an RN Case Manager, you will play a vital role in collaborating with clinical teams to provide complex case management and enhance the connection between patients and their primary care physicians. Your primary responsibility will be to assist patients in achieving their highest level of wellness, managing a specific population that may include complex medical conditions and socio-economic or mental health co-morbidities. You will work closely with a team of patient care navigators and other healthcare professionals to optimize patient health through comprehensive assessment, planning, implementation, coordination, monitoring, and evaluation of available services.
This is a remote position that may require occasional travel (10%-15%). Candidates should reside or be willing to relocate within 90 minutes of Houston. We appreciate your understanding.
What You'll Be Doing:
Conducting comprehensive assessments of healthcare and psychosocial needs for patients.
Reviewing and amending patient navigator interviews to ensure accurate information.
Developing, implementing, and maintaining individualized care plans that adhere to internal protocols and accreditation standards.
Delivering evidence-based clinical interventions aligned with the goals of individualized care plans.
Collaborating with patient navigators to manage non-clinical elements of care, such as scheduling appointments, arranging transportation, and addressing social determinants of health (SDOH).
Providing ongoing outreach to patients, continuously monitoring data and adjusting care plans as needed.
Working with primary care physicians to create specific escalation plans for managing chronic conditions.
Educating patients about their conditions and treatment options.
Advocating for patients and assisting them in accessing necessary services and resources.
Following up on referrals for services or resources.
Maintaining accurate documentation in the electronic health record as per protocol.
Utilizing evidence-based clinical protocols and quality metrics to guide care.
What You'll Need:
A valid Registered Nurse license in good standing.
A minimum of 3 years of RN case management experience in an outpatient setting.
Certification in Case Management (CCM) is preferred; must obtain CCM within one year of employment.
Supervisory experience is a plus.
Excellent written and verbal communication skills to interact empathetically with patients, families, and interdisciplinary teams.
Strong computer skills, with the ability to learn multiple EMR and case management documentation systems.
Ability to meet accreditation and quality standards, including NCQA and HEDIS.
Preferred Qualifications:
Bilingual in English and Spanish is a plus.
Benefits:
While you work hard to advance value-based healthcare, we are committed to ensuring you and your family have the support you need. Our benefits include:
Remote Work Flexibility: Enjoy the convenience of working from home, allowing you to focus on your professional and personal needs.
Comprehensive Health Coverage: We offer medical, dental, and vision plans to keep you and your family healthy.
Retirement Planning: Our 401(k) plan includes a 3% employer match on your contributions.
Life and Disability Insurance: We provide peace of mind with life and disability insurance, along with optional additional coverage.
Employee Assistance Program (EAP): Support is available through our EAP for challenging times.
Flexible Time Off: Tailored time off to help you achieve work-life balance.
Paid Parental Leave: Time off to welcome a new family member.
Professional Development: We offer resources and opportunities for your career growth and learning.
Compensation:
The base salary for this position ranges from $80,000 to $85,000 per year, paid bi-weekly. Final compensation decisions will consider various factors, including experience, education, location, and certifications.
Our Commitment to Equal Opportunity Employment:
We believe in diversity, inclusion, and belonging as core values. We are an equal opportunity employer, committed to making employment decisions without regard to race, religion, color, age, sex, sexual orientation, national origin, disability, military status, or any other classification protected by law. Our management team is dedicated to ensuring fairness in hiring, promotion, and treatment throughout employment.
This position requires adherence to all security policies and procedures to protect all protected health information (PHI) and intellectual properties. Responsibilities may be further defined based on the specific requirements of the role.
Employment Type: Full-Time
Salary: $ 80,000.00 85,000.00 Per Year
Job Tags
Weekly pay, Full time, Relocation, Flexible hours,