RN Case Manager III

Job description

**This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a RN Case Manager III based in United States.** The RN Case Manager III provides high-level, member-centered care coordination for individuals with complex and significant healthcare needs. This role uses evidence-based clinical practices to help members navigate the healthcare system and achieve their goals of care. You will conduct individualized assessments, coordinate services across care settings, and support safe transitions throughout the healthcare continuum. The position combines clinical expertise, advocacy, resource coordination, and analytical decision-making to address both medical and social needs. You will collaborate closely with physicians, providers, internal teams, members, families, and community resources to improve outcomes and experiences. The ideal candidate is an empathetic and confident registered nurse who can manage multiple complex situations while working effectively in a fast-paced environment. This is an opportunity to make a meaningful impact on vulnerable populations while contributing to quality care, improved coordination, and more sustainable healthcare outcomes. ### Accountabilities - Provide member-centered, evidence-based case management services for individuals with complex and high healthcare needs. - Conduct comprehensive assessments to understand members’ clinical conditions, functional needs, goals of care, barriers, and social determinants of health. - Develop and coordinate individualized care plans that align healthcare services and community resources with each member’s needs and preferences. - Support safe and effective transitions between hospitals, outpatient care, home care, and other healthcare settings. - Help members and families navigate complex healthcare systems, understand available services, and access appropriate resources. - Collaborate with physicians, healthcare providers, internal teams, community organizations, and other stakeholders to coordinate care and address barriers. - Apply clinical judgment and analytical decision-making to identify risks, prioritize interventions, and determine appropriate next steps. - Advocate for members by creatively identifying, negotiating, and accessing resources that support improved health and quality-of-life outcomes. - Address chronic conditions, activities of daily living, instrumental activities of daily living, and social factors that may affect healthcare outcomes. - Contribute to department performance benchmarks while maintaining high standards of customer service and clinical quality. - Support team effectiveness and organizational change by modeling positive behaviors, sharing knowledge, and contributing to a collaborative environment. - Perform additional duties and responsibilities as assigned. **Requirements** - Associate’s degree in Nursing or equivalent relevant experience, plus at least 3 years of clinical or acute care nursing experience beyond the degree requirement. - Current, unrestricted Registered Nurse license in the state of residence. - Strong clinical foundation and general understanding of chronic conditions, the healthcare continuum, ADLs/IADLs, and social determinants of health. - Experience working with vulnerable or complex populations in clinical, home care, telephonic, or similar healthcare environments is preferred. - Direct case management experience is strongly preferred. - Ability to work effectively with diverse populations across different age groups, cultural backgrounds, socioeconomic circumstances, and medical or surgical specialties. - Strong communication and relationship-building skills, particularly when collaborating with physicians, healthcare providers, members, families, and other stakeholders. - Excellent internal and external customer service skills, with a professional, empathetic, persistent, pragmatic, and solutions-oriented approach. - Strong analytical, clinical reasoning, and decision-making skills, including the ability to make sound judgments under pressure. - Ability to take initiative, negotiate effectively, identify creative solutions, and lead efforts to access appropriate resources. - Ability to adapt positively to change and contribute constructively to team and organizational initiatives. - Excellent written and verbal communication skills, including confidence presenting information in group settings. - Ability to manage multiple complex issues and priorities efficiently in a fast-paced and continuously changing environment. - Experience working with multiple computer systems, healthcare platforms, and technology tools. - Certified Case Manager certification is preferred, with a commitment to obtain the credential within two years of hire if not already certified. - Must be legally authorized to work in the United States at the time of application; visa sponsorship is not available for this position. - For this remote role, candidates must reside in an eligible U.S. state where the employer is authorized to employ workers. **Benefits** - Full salary grade of $72,100–$123,600, with a typical hiring range of $72,100–$97,850. - Compensation determined based on factors such as education, experience, certifications, licensure, role scope, internal equity, and market data. - Competitive medical, dental, and vision coverage. - Paid time off and paid holidays. - Paid volunteer time off. - 401(k) contributions. - Caregiver support services. - Additional employee benefits designed to support health, well-being, and work-life balance. - Remote work arrangement with eligibility based on approved U.S. states.