*Nurse Case Manager II - Transition OD Care Registered Nurse

Remote, FL 32301

Posted: 06/13/2025 Job Number: 152833

Job Description


Job Title: Nurse Case Manager II - Transition OD Care RN Address: Tampa, FL Hours: M–F, 8:00am – 5:00pm (Full Time) Job Description
  • Applies critical thinking and evidence-based clinical criteria to support contractual rebalancing goals.
  • Completes at least 10 NF member assessments weekly.
  • Supports the Health Plan Rebalancing Initiative goal of successful transitions.
  • Assesses, identifies, screens, and transitions NH members into the community.
  • Follows up on CM referrals and visits current NH members in-person at least twice a week.
  • Completes telephonic or in-person contact to assess the home prior to discharge.
  • Conducts an in-person Significant Change Visit with member and Rep if applicable within 5 days of transition.
  • Coordinates provision of services as needed, establishes Plan of Care, and documents all actions taken.
  • Contacts facility's Business Office once a week to follow up on members' census.
  • Works collaboratively with case managers to identify high-risk community members.
  • Drives enhanced value of health care to increase member satisfaction and retention.
  • Engages in building strong relationships that contribute towards member satisfaction and retention.
  • Involved in at least two community relations events per year.

Critical Information
  • Candidate must reside in the Tampa area and be able to travel to facilities within the regions/neighboring counties.
  • Local travel up to 75% required.
  • Prior CVS/Aetna work experience: No.
  • Verifyable High School Diploma or GED Required: Yes.
  • Is this request for Peak Season? N/A - Not RAMP Related.
  • Onsite Requirements: Fully remote (never coming onsite).

Education/Licenses Needed
  • Active, unrestricted, and good standing RN license in the state of Florida.
  • Education: Associate Degree Required and BSN preferred.
  • Minimum 2 years of clinical experience required.
  • Bi-Lingual Spanish/English required.
  • Position requires proficiency with computer skills, including navigating multiple systems.
  • Ability to work in a fast-paced environment.

This is an AI-generated job description, therefore this does not remove human decision-making. ```
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