Nurse Case Manager I (Healthcare)

Location: Northern Virginia, Virginia, United States; primarily virtual with required in-person training and occasional onsite work. Candidates must live within reasonable commuting distance of a posting location.

Salary: $77,280–$115,920 per year.

Company

hirify.global is a Fortune 25 healthcare company focused on improving lives and communities and simplifying healthcare.

What you will do

• Perform care management for members with complex and chronic care needs within the scope of RN licensure.
• Assess member needs and develop individualized care management plans.
• Implement care plans by coordinating authorizations, referrals, and internal and external resources.
• Monitor outcomes, evaluate plan effectiveness, and modify care plans as needed.
• Collaborate with Medical Directors, Physician Advisors, providers, claims teams, and other stakeholders.
• Support hospital discharge planning, reimbursement negotiations, and resolution of provider or service issues.

Requirements

• Bachelor’s degree in a health-related field and at least three years of clinical experience, or an equivalent combination of education and experience.
• Current, unrestricted RN license in the applicable state or states.
• Multi-state licensure is required when providing services across multiple states.
• Residence within reasonable commuting distance of a posting location is required unless a legally required accommodation applies.

Nice to have

• Previous case management experience.
• Behavioral health or experience supporting people with intellectual or developmental disabilities.
• Home health, utilization management, or hospital discharge planning experience.
• Case Manager certification and a bachelor’s degree in a health or human services field.

Culture & Benefits

• Virtual-first work arrangement for this role with required in-person training and onsite activities when needed.
• Medical, dental, vision, disability, life insurance, and wellness benefits.
• Paid holidays, paid time off, and incentive bonus programs.
• 401(k) with company match and employee stock purchase plan.
• Financial education resources and professional growth support.