RN Case Manager

We are seeking a dedicated Field Care Manager Nurse II (RN Case Manager) to support Medicare and Medicaid members through comprehensive care coordination, clinical assessment, and ongoing case management. This field-based role is responsible for conducting in-home and community-based assessments, developing personalized care plans, coordinating services, and helping members achieve optimal health outcomes.

This position is ideal for an experienced Registered Nurse who enjoys working independently, building relationships, and making a direct impact on member health and well-being.

Responsibilities

Care Management & Case Coordination

• Manage a caseload of Medicare and Medicaid members
• Perform in-home, community-based, and telephonic assessments
• Evaluate members' physical, behavioral, environmental, and psychosocial needs
• Develop, implement, and update individualized care plans
• Monitor member progress and adjust care plans as needed
• Identify and address barriers to healthcare access and treatment adherence
• Ensure members receive services in the least restrictive and most appropriate setting

Clinical Oversight

• Provide clinical guidance and support for members with complex medical conditions
• Complete medical complexity assessments and clinical reviews
• Coordinate care among physicians, specialists, caregivers, and other providers
• Support disease management and chronic condition management initiatives
• Promote preventive care and wellness programs

Interdisciplinary Care Team (ICT) Collaboration

• Serve as the primary point of contact for the member's interdisciplinary care team
• Coordinate with caregivers, primary care providers, community resources, and support services
• Facilitate communication between all involved care partners
• Advocate for members to ensure appropriate services and support are provided

Community Resource Navigation

• Connect members with community programs and resources
• Assist with social determinants of health needs, including:
• Housing support
• Community services
• Educational resources
• Caregiver assistance
• Social service programs

Required Qualifications

• Active Michigan Registered Nurse (RN) license with no disciplinary actions
• Registered Nurse, Nurse Practitioner, or Clinical Nurse Specialist designation
• Minimum of 2 years of healthcare and/or case management experience
• Must reside in Michigan
• Ability to travel throughout Wayne and/or Macomb Counties for face-to-face member visits
• Experience working with adult populations and chronic disease management
• Knowledge of community health resources and social service agencies
• Excellent communication and relationship-building skills
• Strong assessment, care coordination, and problem-solving abilities
• Ability to work independently with minimal supervision
• Experience using:
• Electronic Medical Records (EMR)
• Microsoft Word
• Microsoft Excel
• Microsoft Outlook
• Strong computer, keyboarding, and web navigation skills
• Ability to work full-time Monday through Friday
• Valid driver's license
• Reliable vehicle and personal automobile insurance meeting required coverage limits
• Dedicated home office with a private, secure workspace
• High-speed internet access suitable for remote work
• Ability to complete required Tuberculosis (TB) screening

Preferred Qualifications

• Bachelor of Science in Nursing (BSN)
• In-home assessment and care coordination experience
• Managed care experience
• Medicaid Long-Term Care experience
• Experience with health coaching, wellness, and preventive care programs
• Bilingual language skills, including:
• Spanish
• Arabic
• Chaldean Neo-Aramaic