Job Description

Job Title: Registered Nurse (RN) – Case Manager

Location: Hamilton, Butler, Clermont, or Warren Counties, OH

Schedule: Monday to Friday, 8:00 AM – 5:00 PM

Key Responsibilities:

• Conduct comprehensive assessments of referred members' needs and eligibility.
• Determine appropriate interventions and services by evaluating the member’s benefit plan and available resources.
• Apply clinical judgment and established guidelines, protocols, and policies to ensure appropriate benefit administration.
• Utilize case management and quality management processes in compliance with regulatory and accreditation standards.
• Document all case activities accurately and in a timely manner.
• Communicate effectively with members, providers, and other stakeholders.
• Perform member visits in their homes and complete documentation remotely from a home office setting.

Qualifications:

• Registered Nurse (RN) with a current, unrestricted state license.
• Minimum of 3 years of clinical experience (hospital, home health, or ambulatory care setting preferred).
• Experience in healthcare or managed care industry required; case management experience preferred.
• Proficiency in computer systems, including navigating multiple platforms and strong keyboarding skills.
• Excellent verbal and written communication skills.
• Ability to prioritize, multitask, and thrive in a fast-paced environment.
• Must be comfortable with sedentary work, including extended periods of sitting, computer use, and phone communication.

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