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:
- Active RN or LPN license (required)
- Bachelor’s degree in Nursing or a health-related field (preferred for RN candidates)
- Minimum of 2 years of clinical experience (critical care experience preferred)
- Previous experience in case management, utilization review, or discharge planning
- Familiarity with healthcare claims, risk assessment, and insurance processes
- Experience in a business, administrative, or corporate setting is a plus
- Ability to work onsite full-time in Timonium, MD
Compensation & Benefits:
- Range: $85,000-$95,000- pending experience and education
- Comprehensive benefits package for full-time employees
*Ideally looking for a Fall 2025 start!
#HC123
Job Tags
Full time, Local area,