Hybrid Registered Nurse Case Manager

Job Title: Hybrid Registered Nurse Case Manager

Hourly Rate: $40.00-43.00
Work Schedule: Monday–Friday, 8 AM – 5 PM EST

Work Location:

• Remote with travel - field-based with 1–2 remote administrative days weekly
• Locations:
• • Rocky Mount, NC – 1 opening
  • Charlotte, NC ch–1 opening  RN only
• Note: Candidate must reside within a 2 hour radius of assigned region for member visits.
• Travel: Approximately 80% field-based; valid driver’s license required. Mileage and lodging reimbursed.

Position Purpose

The LTSS (Long-Term Services and Supports) Service Care Manager is responsible for assessing, developing, and coordinating holistic care management activities for members with long-term care needs. This role focuses on improving quality outcomes, ensuring cost-effective care, and supporting members and families through education and coordination of available services.

This position is member-facing and may also include interaction with providers and community resources.

Key Responsibilities

• Manage a caseload of members receiving LTSS and coordinate their care plans.
• Conduct in-person and telephonic assessments with members, caregivers, and providers.
• Develop individualized service care plans addressing physical, social, and environmental needs.
• Monitor service delivery and follow up to ensure continuity of care and identify gaps in services.
• Collaborate with healthcare providers, discharge planners, and physicians to coordinate acute and long-term care.
• Authorize and coordinate referrals and resources to support members’ goals.
• Document assessments, progress, and communications in electronic medical records.
• Assist members with filing and resolving complaints and appeals.

Qualifications

Education:

• Bachelor’s degree required

Licensure (Required):

• RN (Registered Nurse) and/or LCSW/LCSW-A

Experience:

• 2–4+ years of physical health care management experience required
• 4–6+ years preferred
• Background in hospital case management, home health, home care, utilization management, discharge planning, or long-term care
• Experience with Microsoft Office and electronic medical records (EMR) systems

Disqualifiers:

• Candidates with only psychiatric, counseling, nursing home, or rehab experience
• New graduates with no bedside or hospital case management background

Additional Information

• Work is primarily field-based with 1–2 remote administrative days weekly.
• Quarterly in-person team meetings may be required.
• Candidate must be authorized to work in the U.S. without visa sponsorship.
• Driving is required; MVR check will be conducted.
• Clinical licensure verification required.

About the Team

The LTSS Service Care Manager team supports members enrolled in the two different health plans. The team culture emphasizes collaboration, accountability, and person-centered care. Members of this team play a vital role in improving health outcomes for individuals requiring long-term support services.

Please Contact:

Katherine Skelton

586-710-0022