Case Manager Nurse RN (Medtech)

TL;DR

Case Manager Nurse RN (Medtech): Providing telephonic case management between providers, patients, and caregivers to ensure cost-effective, high-quality healthcare for insurance participants with an accent on clinical assessment and treatment planning. Focus on coordinating multidisciplinary care, performing utilization reviews, and advocating for patient needs to reduce overall costs.

Location: Remote (Must be based in the United States)

Compensation: $36–$38 per hour

Company

hirify.global is a personalized health platform providing health plan administration and holistic wellbeing solutions to employers and health systems.

What you will do

• Conduct thorough patient assessments covering physical, psychosocial, and financial needs.
• Develop and monitor treatment plans for standard and catastrophic cases in collaboration with multidisciplinary providers.
• Research paid claim data to identify appropriate health programs for members.
• Advocate for patients to facilitate quality care and reduce healthcare costs.
• Perform utilization reviews and maintain detailed clinical documentation in accordance with HIPAA.
• Mentor LVNs and provide guidance on complex clinical cases.

Requirements

• Graduation from an accredited Registered Nursing (RN) program.
• Possession of a current California RN license and a multi-state license.
• Minimum 5 years of medical/surgical or acute care experience.
• At least 2 years of experience in case management.
• Knowledge of medical claims and ICD-10, CPT, and HCPCS coding.
• Proficiency in Microsoft Office Suite.

Culture & Benefits

• Part-time schedule designed around personal availability and priorities.
• Access to professional learning and development opportunities.
• Mentorship and skill-building for career advancement.
• Competitive hourly compensation.
• Technology and equipment support provided.