Case Management Nurse

Job Description

We are seeking a career-minded RN Case Manager in Timonium, MD. This is an excellent opportunity for a motivated RN or LPN who is eager to grow professionally within an innovative and mission-driven organization.

Position Summary :

The Medical Case Manager is responsible for assessing, planning, coordinating, monitoring, and evaluating the services and resources available to support an optimal treatment plan for each member. This role plays a key part in ensuring continuity of care across different settings in a cost-effective and patient-focused manner.

Key Responsibilities :

• Coordinate care and services for members across local and national providers
• Serve as liaison among patients, primary care providers, specialists, and health plans
• Monitor ongoing care needs, including pharmaceuticals and durable medical equipment (DME)
• Facilitate discharge planning and care transitions
• Track service authorizations and manage approval / denial processes
• Perform medical risk assessments for Stop Loss carriers
• Manage assigned caseloads, providing insight into financial exposure for each case

Qualifications :

Compensation & Benefits :

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