As a registered nurse, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner. You will promote wellness, problem-solve, and assist members in realization of their personal health-care related goals. This role includes telephonic member and provider outreach, data collection and analyzation, and clinical review.
As a Case Management Nurse I, you will serve as a key advisor who actively engages with members through a variety of channels to foster a caring and trusting level of connection in order to support their chronic and/or complex health care needs and concerns. You will create and manage unique, individualized care plans that ensure the best possible health care goals and complex health needs are reasonably met. You will partner with members, members’ families, health care providers and community resources to coordinate and facilitate care and services.
Helping patients feel supported, heard, and guided—right from your home, transforming how patients experience healthcare by combining clinical expertise with compassionate, person-centered support. As a Remote RN Case Manager, you’ll build trusted relationships with patients by phone, helping them navigate complex health needs, understand their care plans, and improve their overall well-being.
This is a great opportunity to join Cycle Pharmaceuticals as a Clinical Education Manager for Immunology, where you’ll work closely with healthcare professionals, patients/caregivers, clinical institutions, specialist pharmacies and internal teams. You will provide education and advice and ensure every patient receives the highest level of support on their treatment journey.
Are you a Utilization Review Nurse who loves making a real impact from the comfort of your home? This position requires a master-level critical thinker and problem-solver to join a collaborative remote team; experience with Cerner, InterQual, and Xsolis programs is required. If you're eager to leverage your expertise, work autonomously, and be part of a supportive, 100% remote team dedicated to quality patient outcomes, apply now!
The UM Nurse Specialist conducts clinical reviews to ensure that services provided to members meet clinical criteria and are delivered in appropriate settings. Using clinical expertise, coordinates, documents, and communicates all aspects of utilization and benefit management, handling both prospective (pre-service and concurrent) and retrospective care reviews. They assist providers and members in coordinating care with in-plan providers and preferred out-of-plan providers.