This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Care Manager RN in United States.
This role offers an opportunity to make a meaningful impact on patient outcomes by combining clinical expertise with care coordination and data-driven decision-making. As a Care Manager RN, you will play a central role in evaluating healthcare services, ensuring appropriate resource utilization, and guiding members through their care journey. You will collaborate closely with providers, patients, and internal teams to promote quality, efficiency, and compliance in care delivery. The position operates in a dynamic, fast-paced healthcare environment where critical thinking and adaptability are key. With a strong focus on improving satisfaction and health outcomes, this role is ideal for professionals passionate about patient advocacy and continuous improvement.
Accountabilities:- Conduct utilization management reviews to assess the appropriateness and efficiency of healthcare services, ensuring alignment with clinical guidelines and policies.
- Monitor and analyze care delivery, identifying opportunities for improved outcomes, cost efficiency, and patient satisfaction.
- Collaborate with healthcare providers, members, and internal teams to coordinate care plans and recommend appropriate interventions.
- Educate providers, vendors, and members on care processes, compliance requirements, and available healthcare resources.
- Identify cases requiring additional support such as health coaching or case management and facilitate appropriate referrals.
- Maintain compliance with all regulatory, legal, and ethical standards, including patient privacy and data protection requirements.
- Use data insights to develop strategies that enhance care quality, streamline processes, and strengthen provider relationships.
Requirements:
- Active RN license (state-specific or multi-state compact) with the ability to maintain compliance requirements.
- Minimum of 3 years of progressive clinical experience, ideally within a clinical or managed care environment.
- Strong understanding of utilization management, case management, or healthcare quality assurance practices is preferred.
- Proven ability to analyze clinical and operational data to drive decision-making and improve outcomes.
- Excellent communication skills with the ability to educate, influence, and build relationships across stakeholders.
- Strong organizational and multitasking abilities, with the capacity to manage priorities in a fast-paced environment.
- Proficiency in healthcare systems, documentation tools, and general computer applications.
- Certification in utilization management or a related field is a plus.
Benefits:
- Competitive salary ranging from $68,400 to $105,900 annually, based on experience and qualifications.
- Comprehensive healthcare coverage including medical, dental, and vision plans.
- Retirement savings plan with company contributions.
- Paid time off, holidays, and additional leave programs.
- Opportunities for professional development and certification support.
- Flexible work arrangements and potential remote options.
- Employee wellness programs and support resources.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Why Apply Through Jobgether?
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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