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Posted Dec 23, 2025

Registered Nurse - Case Manager

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Description: • Remote work from home role anywhere in the US with virtual training, • 8:30am - 5pm shift within time zone of residence, • Telephonic case manager with patients and their care team, • Application and/or interpretation of applicable criteria and clinical guidelines, • Applies clinical judgment for risk factors and barriers, • Consults with supervisor and others to overcome barriers, • Utilizes motivational interviewing skills for member engagement, • Identifies and escalates member’s needs appropriately, • Performs medical necessity reviews. Requirements: • 5+ years’ experience as a Registered Nurse with at least 1 year of experience in a hospital setting, • Active, unrestricted license in state of residence, • Willingness to receive multi-state/compact privileges, • 1+ years’ current or previous experience in Oncology, Transplant or Specialty Pharmacy, • 1+ years’ experience documenting electronically using a keyboard, • 1+ years’ Case Management experience or discharge planning, • 1+ years' experience in Utilization Review, • CCM and/or other URAC recognized accreditation preferred, • 1+ years’ experience with MCG, NCCN and/or Lexicomp, • Bilingual in Spanish preferred. Benefits: • Affordable medical plan options, • 401(k) plan (including matching company contributions), • Employee stock purchase plan, • No-cost programs for all colleagues including wellness screenings, • Tobacco cessation and weight management programs, • Confidential counseling and financial coaching, • Benefit solutions that address different needs and preferences, • Paid time off, • Flexible work schedules, • Family leave, • Dependent care resources, • Colleague assistance programs, • Tuition assistance, • Retiree medical access, • Many other benefits depending on eligibility. Apply Job!