Guidehealth - Remote RN Case Manager

Guidehealth

Remote RN Case Manager

Remote Clinical Case Manager Full Time Mid-Level $80,000 - $85,000
South Bend, Indiana, United States

Job Description

This role enhances member health outcomes by managing cases remotely, focusing on navigation through healthcare systems to promote wellness and reduce costs. Registered nurses assess needs, collaborate on plans, and assist with goals for patients in value-based care settings. Using telephonic outreach and data analysis, they facilitate access to reliable services.

Guidehealth leverages predictive analytics and healthguides to operationalize care delivery, dedicating efforts to affordable healthcare with AI-powered support for patients and providers across the US. Physician-led teams build patient-provider connections across diagnoses, aiming to embed services that drive high-quality outcomes.

Case managers analyze data for eligibility in programs, coordinate equitable care, manage assignments with documentation, participate in committees, and educate members on system navigation. They use EMRs, spreadsheets, Outlook, and assessment tools. Interactions may include phone-based outreach with providers and clients. One constraint involves maintaining a HIPAA-compliant private office with high-speed internet for remote workflows.

Years of experience influence pay, with ranges from $80,000 to $85,000 annually plus parental leave options. Remote work required, with flexible hours. Benefits include medical, dental, vision, life, disability, EAP, paid time off, and opportunities for growth.

Responsibilities

  • Analyze data for program eligibility
  • Coordinate timely care per HMO processes
  • Manage cases with outreach and closing
  • Participate in QM/UM meetings
  • Educate members on health systems

Requirements

  • Current Illinois RN License
  • 5+ years healthcare experience
  • Case Management and Chronic Condition expertise
  • Knowledge of managed care and reimbursement
  • Remote/telephonic work history
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