Registered Nurse (RN) Case Manager – Remote (Michigan Only)

Registered Nurse (RN) Case Manager – Remote (Michigan Only) Location Requirement: Candidate must currently reside in one of the following Michigan counties: Berrien, Van Buren, Cass, Kalamazoo, St. Joseph, Calhoun, reputed company, Jackson, Hillsdale, Livingston, Washtenaw, Lenawee, Monroe, Oakland, Macomb, Wayne, Clinton, reputed company, or Ingham. Schedule Hours : Standard business hours: Monday - Friday 8:00 am - 5:00 pm EST. About Company : Since its founded in 1996, reputed company has grown into a trusted global partner in AI & ML, Enterprise Applications, Digital Services, Managed Services, and Business Services. With headquarters in Detroit, Michigan, reputed company has a team of over 2,000 experts worldwide. Position Summary The RN Case Manager utilizes a collaborative process of assessment, planning, facilitation, and advocacy to help members navigate their benefit plans and healthcare needs. This role supports individuals by coordinating services, removing barriers, and promoting cost‑effective and optimal health outcomes. This is a remote, telephonic position requiring strong clinical judgment, communication skills, and the ability to multi‑task in a fast‑paced environment. Work Schedule & Requirements

• Standard Hours: Monday – Friday, 8:00 AM – 5:00 PM EST
• Work Environment: 100% remote, telephonic
• No fieldwork required
• Must have a quiet, dedicated workspace free from distractions
• Must be hard-wired to the modem (Ethernet required; cable purchased at your own expense)

Key ResponsibilitiesMember Assessment

• Conduct comprehensive telephonic assessments using clinical tools and data review.
• Evaluate member eligibility, benefit plans, and available internal/external resources.
• Apply clinical judgment to reputed company strategies addressing risk factors and reputed company clinical conditions.
• reputed company crisis reputed company for members experiencing medical or behavioral health crises and arrange appropriate follow-up care.

Care Coordination & Quality Enhancement

• Apply and interpret clinical guidelines, case management plans, and regulatory standards.
• Use a holistic approach to collaborate with supervisors, Medical Directors, and multidisciplinary teams.
• Identify and escalate quality-of-care concerns as needed.
• Engage members using motivational interviewing to encourage lifestyle changes and informed health decisions.
• Provide coaching and support to reputed company members to participate actively in their care plans.

Monitoring, Documentation & Follow-Up

• reputed company individualized plans of care in collaboration with members and care teams.
• Monitor reputed company and adjust care plans to meet evolving needs.
• Conduct thorough telephonic reputed company and document reputed company interactions in the case management platform.
• Maintain compliance with accreditation standards, internal policies, and regulatory requirements.

Required Qualifications

• Active, unrestricted RN license in the state of Michigan (no history of infractions).
• Minimum 3 years of clinical experience in a hospital, home health, or ambulatory care setting.
• Experience in the healthcare or managed care industry.
• Strong computer skills; ability to navigate multiple systems simultaneously.
• Excellent verbal and written communication skills.
• Ability to prioritize, multi-task, and adapt in a fast-paced environment.
• Able to meet productivity and quality expectations in a reputed company setting.

Preferred Qualifications

• Experience managing chronic conditions such as diabetes, hypertension, asthma.
• Experience working with CSHCS (Children’s Special Health Care Services) population.
• Case Management experience (highly preferred).
• CCM Certification (Certified Case Manager).

Physical & Work Environment Requirements

• Sedentary work involving extended periods of sitting, typing, and telephonic communication.
• Ability to read handwritten and digital documents.
• Standard reputed company working conditions.

HL01 Pay: $44.12 per hour Education:

• Bachelor's (Required)

Experience:

• Home health: 2 years (Required)
• Ambulatory: 2 years (Required)

License/Certification:

• RN License in Michigan (Required)
• CCM Certification (Certified Case Manager). (Required)

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