Nurse Case Manager (RN)-Field & Remote-{171308}
Job Description
Nurse Case Manager (RN)-Field & Remote-{171308}
Location: Field-based in Northern Virginia + Work From Home (WFH)
Must reside in/near: Sterling, Reston, Chantilly, Oakton, Herndon (VA)
Travel: Up to 75% local travel (remaining time WFH)
Pay Rate: $44.14/hr.
Schedule: Monday-Friday, 8:00am-5:00pm (40 hours/week)
Overview
We’re hiring a Nurse Case Manager (RN) to support members through clinical case management, using assessment tools and data review to identify needs and eligibility, coordinate services, and drive optimal health outcomes. This role requires strong clinical judgment, organized documentation, and the ability to work across multiple systems while aligning with benefit plans, clinical guidelines, and regulatory standards.
Key Responsibilities
- Conduct comprehensive assessments for referred members (needs, eligibility, barriers, and risks)
- Develop, implement, and drive case plans toward resolution and appropriate services/resources
- Apply clinical criteria and guidelines to support accurate benefit administration
- Coordinate care and resources while maintaining a member-focused approach
- Document and manage cases in multiple systems while meeting quality and productivity expectations
Job Requirements
Required Qualifications
- Active, unrestricted RN license
- 3+ years of clinical practice (hospital, home health, ambulatory, or similar settings)
- Healthcare and/or managed care experience
- Strong computer skills (comfortable working in multiple systems, keyboarding, documentation)
Preferred Qualifications
- CCM (Certified Case Manager) strongly preferred
Keywords
Nurse Case Manager, RN, Registered Nurse, Case Management, Managed Care, Utilization Management, Care Coordination, Member Assessment, Clinical Assessment, Case Planning, Care Plan, Discharge Planning, Clinical Guidelines, Clinical Criteria, Benefits Administration, Documentation, Remote, Work From Home, Field Based, Local Travel, Northern Virginia, Sterling VA, Reston VA, Chantilly VA, Oakton VA, Herndon VA, CCM, Certified Case Manager, Healthcare