Case Manager Nurse RN

Location: Remote, United States

Salary: $35.00–$40.00 per hour, depending on location, skills, and experience.

Company

hirify.global provides a personalized health platform combining health plan administration, wellbeing solutions, and comprehensive care navigation for employers, health plans, and health systems.

What you will do

• Conduct comprehensive physical, psychosocial, emotional, spiritual, environmental, and financial assessments with patients.
• Review claims data and identify members who need case management or wellness programs.
• Develop individualized treatment plans for standard and catastrophic cases with patients, caregivers, community resources, and multidisciplinary providers.
• Monitor interventions, evaluate outcomes, perform utilization reviews, and adjust treatment plans.
• Coordinate communication across patients, families, providers, employers, and care teams while advocating for access to quality care.
• Document cases confidentially in Eldorado and UM Web, prepare case management reports, implement cost-management strategies, and mentor LVN colleagues.

Requirements

• Graduate of an accredited Registered Nursing program.
• Current California RN license and a multi-state license required.
• At least five years of medical/surgical or acute care experience, including two years in case management, or an equivalent combination of education and experience.
• Case management, emergency room, critical care, or other relevant clinical experience.
• Knowledge of medical claims processing, ICD-10, CPT, HCPCS coding, community resources, and alternate funding programs.
• Proficiency with Microsoft Office Suite and case management platforms such as Eldorado and UM Web.

Culture & Benefits

• Full benefits package effective from day one, including medical and dental coverage.
• Paid time off, mental health support, retirement planning, and financial protection.
• Professional development, career progression, and learning budgets.
• Mission-driven environment focused on improving health outcomes and valuing diverse perspectives.