medicare advantage Jobs

This remote position serves as a Complex Case Manager RN, providing clinical oversight for a designated panel of members with varying health needs. The role involves assessing health management requirements, utilizing data analytics and clinical judgment to identify appropriate interventions, and managing an active caseload. Key responsibilities include developing comprehensive care plans, addressing barriers to care, coordinating with multi-disciplinary resources, and monitoring clinical and financial outcomes to ensure quality standards are met. The position requires a current RN license and seven years of relevant clinical or case management experience. This opportunity is appealing for its focus on professional autonomy, allowing the incumbent to work with moderate independence in a high-performing team environment. The role emphasizes cultural competency and the use of motivational techniques to support diverse populations. While primarily office-based, the position offers remote work flexibility with minimal travel requirements, making it suitable for professionals seeking a balance between clinical expertise and administrative oversight in a supportive healthcare setting. View more