USRN Case Manager (Utilization Management) at Limitlessli | Torre

USRN Case Manager (Utilization Management)

You'll elevate patient care and outcomes by developing individualized plans from home.
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Full-time

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Remote (for Philippines residents)
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Emma of Torre.ai
22 days ago

Requirements and responsibilities


About LimitlessliAt Limitlessli we specialize in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. Leveraging our extensive global network, we connect clients with highly qualified professionals, offering tailored services to meet our clients' unique business needs.The Opportunity:We are seeking a qualified and compassionate US Registered Nurse (USRN) Case Manager to join our healthcare team. In this role, you will assess, plan, coordinate, and monitor patient care to ensure high-quality, cost-effective outcomes.You will collaborate with physicians, interdisciplinary teams, patients, and families to develop individualized care plans, facilitate care across the continuum, and support improved clinical outcomes while maintaining patient satisfaction.This position is remote and offers you the flexibility of working from home.Key responsibilities include:Conduct comprehensive clinical, functional, psychosocial, and behavioral assessmentsDevelop, implement, and monitor individualized care plans with measurable goalsCoordinate care across providers, facilities, and community resourcesIdentify risks, barriers, and gaps in care and initiate appropriate interventionsFacilitate referrals to disease management and long-term care programs as neededMaintain accurate and timely documentation of assessments, care plans, and follow-upsParticipate in Interdisciplinary Care Team (ICT) meetings and present case updatesEducate patients and families on care plans, self-management, and available resourcesEnsure compliance with HIPAA, regulatory standards, and internal policiesSupport continuity of care during transitions (e.g., hospital discharge, facility transfers)Assist in audits, reporting, and quality improvement initiativesQualifications & RequirementsActive US Registered Nurse (RN) licenseExperience in case management, utilization review, or managed care preferredStrong understanding of managed care principles and healthcare systemsFamiliarity with clinical guidelines such as InterQual, Milliman, or similar is an advantageExcellent communication, coordination, and documentation skillsStrong organizational skills with the ability to manage multiple casesProficiency in Microsoft Office and clinical documentation systemsService Fee:Industry standards applicable to the state depending on work experience and level of expertise.Hours:US Pacific Standard Time (PST) - Monday to Friday - 9am to 6pmWhy Limitlessli?We embrace the flexibility and convenience of a remote working environment, and you will collaborate with an international team while contributing to our growing business, all from the comfort of your home.Essential requirements:You will need to have some essential tools – a reliable computer and noise-canceling headset, a second monitor for enhanced productivity, and a stable internet connection. You’ll also be required to have a backup internet connection, ensuring that you’re well-equipped to complete your work seamlessly.JOIN OUR TEAM!!
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