Guidehealth is hiring a Remote RN Case Manager to build trusted relationships with patients by phone, helping them navigate complex health needs and improve overall well-being. You'll conduct assessments, develop care plans, and coordinate care to support patients' health journeys.
What You'll Do
- Conduct in-depth telephonic assessments to understand each patient's medical, psychosocial, and social needs.
- Review and update medical histories, including medications, chronic conditions, and preventive care.
- Develop individualized care plans and guide patients through their treatment goals and care options.
- Provide empathetic, evidence-based education on chronic disease management and preventive health.
- Monitor progress by phone, adjusting care plans and ensuring patients stay connected to their providers.
- Complete Medicare Annual Wellness Visits (AWVs) via telehealth under physician supervision.
- Partner with Healthguides who support non-clinical needs like scheduling, transportation, food assistance, and SDOH resources.
- Perform proactive outreach and timely follow-ups to maintain continuity of care and patient engagement.
- Advocate for patients, helping them access the right resources at the right time.
- Document clearly and accurately in the EHR and care-management systems during and after calls.
- Support quality outcomes (HEDIS, NCQA) by coordinating preventive services and managing chronic conditions.
- Participate in virtual meetings, ongoing education, and clinical training to stay current with care standards.
- Use multiple communication methods (phone, text, patient portals, email, AI-supported tools) to reach high-risk patients.
- Collaborate in AI-driven outreach programs that help connect with vulnerable populations.
- Protect patient privacy in a secure, private home workspace.
- Perform additional responsibilities as needed to support patients and the care team.
What We're Looking For
- Active Compact Registered Nurse license in good standing.
- 3+ years of RN Case Management experience, preferably in outpatient or ambulatory care.
- Strong critical-thinking and problem-solving skills to anticipate barriers and drive care forward.
- Ability to work independently, manage multiple priorities, and make sound clinical decisions remotely.
- Outstanding communication—warm, clear, confident, and patient-focused.
- Excellent telephonic interviewing skills and the ability to document accurately in real time.
- High comfort level with technology: EMRs, care-management systems, multi-screen workflow, Microsoft Office, and telecommunication tools.
- Understanding of accreditation and quality standards (NCQA, HEDIS).
- A quiet, private home office suitable for patient calls and handling PHI.
- Alignment with Guidehealth policies, clinical protocols, and compliance standards.
Nice to Have
- BSN and Case Management certification.
Technical Stack
- EMRs
- Care-management systems
- Microsoft Office
- Telecommunication tools
- AI-supported tools
Team & Environment
You'll partner with Healthguides for non-clinical support.
Benefits & Compensation
- Compensation: $80,000.00 to $83,000.00
- Comprehensive Medical, Dental, and Vision plans.
- 401(k) plan with a 3% employer match to your 6% contribution.
- Life and Disability insurance.
- Voluntary Life options.
- Employee Assistance Program (EAP).
- Paid time off plans.
- Paid parental leave.
- Various resources dedicated to learning and development.
Work Mode
This role is hybrid, with a fully remote company structure.
We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.
