Nurse Case Manager I
About the role
This role enables associates to work virtually full‑time, except for required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Per our hybrid/virtual work policy, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. This position is not eligible for employment‑based sponsorship.
Schedule
Hours: Monday‑Friday 9:00 am‑5:30 pm, with 2‑4 late evening shifts per month (11:30 am‑8:00 pm EST/CST).
Responsibilities
- Ensures member access to services appropriate to their health needs.
- Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
- Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra‑contractual arrangements.
- Coordinates internal and external resources to meet identified needs.
- Monitors and evaluates effectiveness of the care plan and modifies as necessary.
- Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
- Assists in problem solving with providers, claims or service issues.
- Functions as preceptor for new care management staff.
- Works on special projects as assigned by manager.
- Performs other duties as assigned.
Requirements
- BA/BS in a health‑related field and minimum of 3 years of clinical experience; or any combination of education and experience that provides an equivalent background.
- Current, unrestricted RN license in home state required.
- Multi‑state licensure is required if services are provided in multiple states.
Skills
- Certification as a Case Manager is preferred.
- Previous case management experience is preferred.
- Home health experience, utilization management, and/or hospital discharge planning experience is a plus.
Pay
The salary range for this position (based in New York) is $70,560 to $105,840.
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase plan
- 401(k) contribution