Medical Case Management Nurse (RN or LVN)

Job Description

Job Description

Join the BRMS Medical Management Team!

Take your nursing career to the next level with Benefit & Risk Management Services (BRMS) — a trusted leader in self-funded healthcare administration. As a Medical Case Management Nurse, you’ll join a dynamic team that blends clinical excellence with innovation to improve member outcomes and manage healthcare costs effectively.

Working for a Third-Party Administrator (TPA) like BRMS offers a unique and fulfilling experience — you’ll use your nursing expertise to impact not just individual patients, but entire employer groups, helping members receive high-quality care while driving smarter healthcare decisions.

What You’ll Do

Manage cases for members with complex or chronic conditions to ensure appropriate, cost-effective treatment.

Coordinate communication between patients, providers, and insurance partners.

Review clinical information for quality, medical necessity, and benefit optimization.

Track, document, and analyze case activity to identify trends and cost-saving opportunities.

Develop individualized care plans and support members in navigating their healthcare journey.

Collaborate with Utilization Review, Claims, and other departments to ensure seamless medical management.

Participate in reporting, quality assurance, and process improvement initiatives.

What You Bring

Graduate of an accredited school of nursing.

Active California RN or LVN license (required).

Minimum 2 years of acute clinical experience and 1+ year in case management or utilization review .

Knowledge of ICD-10, CPT, and HCPCS coding.

Strong communication, analytical, and organizational skills.

Experience with cost containment, quality assurance, or self-funded plans a plus.

Why Join BRMS

Be part of a collaborative, mission-driven team that values clinical insight and innovation.

Gain unique experience in the self-funded insurance world , where your work impacts both members and employers.

Work alongside experienced healthcare and benefits professionals who are dedicated to excellence.

Enjoy a stable weekday schedule in a supportive, professional environment.

Company Description

Established in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs.

One of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefits

Company Description

Established in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs.\r\n\r\nOne of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefits