Remote Care Management Nurse

Location: Remote work from home within Oregon, Washington, Idaho, or Utah; U.S. licensure eligibility required.

Salary: $36.80–$49.80 per hour expected hiring range in Oregon, Washington, Utah, and Idaho; full range of $34.20–$55.70 per hour. North Dakota ranges are also listed.

Company

Purpose-driven health care organization focused on creating a person-focused and economically sustainable health care system.

What you will do

• Conduct case management activities including assessment, planning, implementation, coordination, monitoring, and evaluation.
• Apply clinical judgment, medical policy, medical necessity guidelines, and evidence-based standards of care.
• Collaborate with physician advisors, customers, and internal departments to resolve claims, quality-of-care, member, and provider issues.
• Recommend resolutions and participate in quality improvement initiatives.
• Respond to inquiries professionally while protecting confidential information.
• Document activities accurately and monitor the effectiveness of care management plans.

Requirements

• Associate’s or bachelor’s degree in nursing or health/human services, or equivalent experience.
• At least three years of direct clinical care, case management, utilization management, disease management, auditing, or retrospective review experience.
• Active, unrestricted U.S. state or territory licensure or certification; an RN license is required for medical care management.
• Must be eligible for licensure in Idaho, Oregon, Utah, and Washington.
• Knowledge of health insurance trends, technology, contractual arrangements, and health care documentation systems.
• Strong communication, customer service, organization, independent workload management, critical thinking, and decision-making skills.

Nice to have

• Experience with AI tools and technologies to improve productivity and professional decision-making.

Culture & Benefits

• Purpose-driven culture focused on trust, innovation, compassion, and sustainable health care.
• Medical, dental, vision, and mental health coverage for employees and eligible family members.
• Health savings account contribution, paid time off, and 10 company-paid holidays.
• 401(k) retirement plan with company matching and potential discretionary contributions.
• Paid parental leave, wellness programs, employee assistance support, and community outreach opportunities.
• Work-from-home setup requires wired internet with minimum upload and download speeds, plus a personal mobile device for MFA.