RN Case Manager (Employer Health Self Insured Plans)

About the role

RN, Case Manager exists to build trusted relationships with employer groups and their employees—serving as the primary clinical point of contact to help them navigate healthcare with clarity, confidence, and support. This role serves as a critical bridge between patients, employers, and care teams—ensuring employees enrolled in self-insured health plans receive the right care at the right time while improving outcomes and reducing unnecessary costs.

Responsibilities

• Serve as the primary relationship owner for assigned employer groups and their employees
• Provide one-on-one guidance, advocacy, and clinical support to help members navigate their healthcare
• Partner with members to create personalized care plans and coordinate care across providers
• Help employees access timely, effective, and cost-conscious care
• This is a hands-on role for someone who enjoys building relationships and being a trusted, go-to resource for both members and employer partners
• Thrives in a highly collaborative, relationship-driven, and client-facing environment
• Is comfortable balancing clinical support with education, navigation, and problem-solving
• Takes ownership and follows through
• Wants their work to make a meaningful, human impact every day

What You’ll Do

• Owning relationships with assigned employer groups and their employees, serving as their primary clinical point of contact
• Supporting members and families through care navigation, education, and ongoing coordination
• Collaborating with Medical Directors, Medical Assistants, providers, employer partners, and internal care teams
• Improving outcomes by guiding members to the right level of care, supporting chronic condition management, and reducing unnecessary utilization
• Advocating for members by navigating the healthcare system, coordinating referrals, and ensuring continuity of care
• Education members on benefits, care options, and preventive health strategies
• Monitoring care plans, progress, and outcomes, and escalating more complex clinical needs when appropriate

How Success Is Measured

• Positive member and employer satisfaction
• Timely, effective care navigation and coordination
• Reduction in unnecessary or avoidable healthcare utilization
• Strong engagement and trust with assigned employer groups
• Effective collaboration with clinical and operational teams

What We’re Looking For

• Active, unrestricted Registered Nurse (RN) license
• 3+ years of clinical experience (case management, care coordination, or population health preferred)
• Experience working with self-insured employers, health plans, or utilization management strongly preferred
• Strong understanding of healthcare navigation, benefits, and cost-conscious care delivery
• Excellent communication and relationship-building skills
• Comfortable working in a remote, tech-enabled environment

Pay

The Pay Range For This Role Is 80,000 - 90,000 USD per year(Phoenix)