RN Case Manager

Guide Healthcare

. Manage case assignments through extensive patient outreach via telephone, documentation, monitoring, case progression, and case closure .

Posted 11/10/2026full-timeRemote • Illinois • United StatesMid-LevelSenior💰 $80,000 - $83,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Case Management and Chronic Condition Management, with a strong focus on patient outreach, data analysis, and effective communication. Proficient in navigating healthcare systems and addressing social determinants to promote member wellness and satisfaction.

Highest-signal resume keywords

Current IL Registered Nurse LicenseCase Management ExperienceChronic Condition ManagementMotivational InterviewingUtilization Review Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case Management PrinciplesHealthcare ManagementReimbursement ComponentsData AnalysisClinical JudgmentProject CompletionMultitasking SkillsEMR Navigation

Soft Skills

Verbal CommunicationWritten CommunicationOrganizational SkillsProblem-Solving SkillsTime-Management Skills

Tools & Technologies

MS WordMS ExcelMS AccessPDF SoftwareOutlook

Certifications & Qualifications

Certification in Case Management

Industry Keywords

Population Health ManagementManaged CareQuality ImprovementCommunity HealthHMO Processes

Tech Stack

Tools & technologies

React

About the role

Key responsibilities & impact

Manage case assignments through extensive patient outreach via telephone, documentation, monitoring, case progression, and case closure
Pull, sort, and analyze data to determine member eligibility for the Population Health management program
Coordinate and provide timely, effective, equitable, safe, and member-centric care while following HMO processes
Meet reporting and documentation standards
Engage in collaborative meetings with department staff and clients
Assist members with wellness and health autonomy by addressing barriers, social determinants, motivators, and psychosocial issues
Educate members on navigating the HMO and healthcare system
Promote quality and cost-effective interventions and outcomes
Support operational aspects of the division to meet customer requirements and satisfaction
Maintain confidentiality of computer programs, medical records, and data
Participate in QM/UM Committee Meetings, including material preparation, minutes, data collection and analysis, reporting, and follow-up tasks
Participate in off-hour/weekend call rotation if applicable
Maintain continued professional growth and education reflecting current nursing care practice
Perform other responsibilities as assigned and according to annual program requirements

Requirements

What you’ll need

Current IL Registered Nurse License
Illinois nursing license and compliance with the Illinois Practice Act
Minimum of five years of experience in a variety of health care settings
Highly experienced in Case Management and Chronic Condition Management
Previous remote and/or telephonic work experience
Knowledge of utilization review, quality improvement, managed care, and/or community health
Basic knowledge of case management principles, healthcare management, and reimbursement components
Experience with motivational interviewing
Excellent clinical judgment
Highly skilled in verbal and written communication
Strong organizational, problem-solving, and time-management skills
Ability to ensure timely completion of projects and assignments
Ability to prioritize and react to rapidly changing business needs
Ability to work independently and remotely with multitasking skills for fast-paced workflows
Software knowledge including word processing and spreadsheets
Computer skills including MS Word, Excel, Access, PDF, and Outlook
Experience navigating multiple EMRs
Ability to provide internet connection with minimum 100 Mbps download and 10 Mbps upload
Certification in Case Management preferred but not required

Benefits

Comp & perks

Work from home / fully remote work arrangement
Comprehensive Medical, Dental, and Vision plans
401(k) plan with a 3% employer match to your 6% contribution
Life and Disability insurance
Voluntary Life options
Employee Assistance Program (EAP)
Paid time off plans
Paid parental leave
Learning and development resources
Necessary work equipment provided at no charge
Flexible remote work arrangement
Virtual meetings and collaboration