Case Manager - 173865

About the role

Piper Companies is seeking a Case Manager (RN) to join a leading organization within the managed care and health insurance industry for a remote position based in North Carolina. The Case Manager (RN) will partner with members, providers, caregivers, and internal stakeholders to coordinate healthcare services, improve clinical outcomes, and ensure appropriate utilization of resources across the continuum of care.

Responsibilities

• Conduct comprehensive clinical assessments and develop individualized care plans that address medical, behavioral, and social needs.
• Coordinate services across healthcare settings, including hospitals, physician offices, rehabilitation facilities, skilled nursing facilities, and home-based care.
• Maintain ongoing communication with members and care teams to evaluate progress, identify barriers, and adjust care strategies as needed.
• Educate members on treatment options, available benefits, community resources, and preventative health measures to support positive outcomes.
• Accurately document case activities, referrals, interventions, and member progress while ensuring compliance with regulatory and organizational standards.

Qualifications

• Active North Carolina RN license or Compact RN license in good standing.
• Minimum of 3 years of clinical nursing and/or case management experience.
• Prior telephonic case management experience within a health insurance carrier, managed care organization, or payer environment.
• Experience supporting Medicare and/or Medicaid populations; behavioral health, adolescent behavioral health, or eating disorder case management experience highly preferred.
• Strong care coordination, assessment, documentation, communication, and member engagement skills with the ability to work independently in a remote setting.

Pay

Salary Range: $25-$35 an hour

Benefits

• Medical
• Dental
• Vision
• 401(k)
• Additional employee benefit offerings