Top 4077 Rn Director Case Management Jobs

Clinical Review & Correspondence RN
Cohere Health —Remote
- $31 - $35 an hour
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Paid parental leave
- Health savings account
Quick Apply
Director of Nursing (DON) - Home Health
Mays Home Health —McKinney, TX
- Full-time
- Nursing
- RN License
- Computer literacy
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Director of Case Management
Great Plains Health —North Platte, NE
- Full-time
- Nursing
- RN License
- Hospital
- Health savings account
- Relocation assistance
Registered Nurse (RN) Case Manager
St. Croix Hospice —Rice Lake, WI
- Weekends as needed
- Nursing
- Clean driving record
- RN License
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8d
Director of Nursing
Lincoln Street Inc. —Springfield, VT
- From $90,000 a year
- Weekends as needed
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse Care Coordinator
Mountain Valley Developmental Services —Glenwood Springs, CO
- $80,600 - $102,960 a year
- Full-time
- Background check
- Nursing
- Blood sampling
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- 403(b) matching
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RN - Registered Nurse: Per Diem or Part Time - Skilled Nursing Rehab
Benchmark Senior Living —Lincoln, MA
- $43 - $47 an hour
- Weekends as needed
- CPR Certification
- Nursing
- Skilled nursing facility
- Paid training
- Health insurance
Quick Apply
12d
Community Health Director (RN)
The Gardens at Town Square —Bellevue, WA
- $130,000 - $150,000 a year
- Full-time
- Background check
- CPR Certification
- Nursing
- Free parking
- AD&D insurance
Quick Apply
RN Team Director, Hospice
AccentCare, Inc. —Fall River, MA
- $95,000 - $115,000 a year
- Full-time
- CPR Certification
- Nursing
- Surgery
- Health savings account
- Paid holidays
Quick Apply
MDS Coordinator | RN
Grand Meadows Rehabilitation & Health Care Center —Asbury, IA
- $42 - $45 an hour
- RN License
- Mid-level
- In-person
- Paid holidays
- Health insurance
RN Patient Care Manager - Hospice
Allay Hospice —Milwaukee, WI
- Full-time
- Nursing
- RN License
- Mid-level
- Disability insurance
- Health insurance
RN, Emergency Department Case Manager
Iredell Memorial Hospital Incorporated —Statesville, NC
- Weekends as needed
- Nursing
- RN License
- Word processing
Quick Apply
7d
Director of Nursing, Residential Division
Northeast Arc —Danvers, MA
- $115,000 - $130,000 a year
- Full-time
- Residential
- 3 years
- Reliable transportation
Quick Apply
Hospice Patient Care Manager - RN Required
Capstone Hospice, LLC —Peachtree Corners, GA
- Full-time
- Nursing
- Current TB test
- RN License
- Disability insurance
- Health insurance
Quick Apply
RN Clinical Manager
Northeast Arc —Danvers, MA
- $118,000 - $119,500 a year
- Full-time
- Mid-level
- 3 years
- Travel
- Disability insurance
- Health insurance
Quick Apply
Psychiatric Nurse Practitioner
Loyal Source —El Paso, TX
- $60.17 - $65.26 an hour
- Weekends as needed
- Nursing
- Microsoft Excel
- Microsoft Outlook
Quick Apply
RN/LPN Per Diem
Benchmark Senior Living —Shelburne, VT
- Up to $42 an hour
- Per diem
- CPR Certification
- Nursing
- Mid-level
- Paid training
- Health insurance
Quick Apply
Patient Care Management Coordinator
Fairview Health Services —Minneapolis, MN
- $48.11 - $69.49 an hour
- Day shift
- Nursing
- RN License
- BLS Certification
Director of Nursing
Chelsey Park Health & Rehab —Dahlonega, GA
- Full-time
- Nursing
- Skilled nursing facility
- Microsoft Outlook
Hospice Field Nurse (RN)
Jewish Association on Aging —Pittsburgh, PA
- Full-time
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply

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Clinical Review & Correspondence RN

Cohere Health -
Remote

Quick Apply

Job Details

Full-time
$31 - $35 an hour

Benefits

Paid parental leave
Health savings account
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Parental leave
Employee assistance program
Vision insurance
401(k) matching
Pet insurance

Qualifications

Correspondence management
Utilization review
RN License
CMS
Zoom
CMS regulatory compliance
Bachelor's degree
Health insurance knowledge
Video conferencing software
Utilization management
Patient care
Resource utilization in healthcare
Bachelor's degree in nursing
Video conferences (communication methods)
Gmail
Continuous process improvement (CPI)
Video conferencing systems operation

Full Job Description

Opportunity Overview:

The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical determinations, and ensuring accurate member and provider communications. In collaboration with Medical Directors and cross-functional partners, this role ensures that clinical decisions are evidence-based, align with regulatory and accreditation standards, and are communicated effectively and timely. Through precise clinical review and documentation, you will help support high-quality care, regulatory compliance, and improved member outcomes.

What you'll do:

Consult with Medical Directors on clinical determinations, medical necessity decisions, and related clinical correspondence
Prepare clear, accurate, and compliant member and provider communications in alignment with regulatory and organizational requirements
Understand regulatory requirements governing utilization management decisions and ensure appropriate application to clinical determinations and communications
Understand when and why member and provider notifications are required, including regulatory and clinical triggers for written communication
Support verbal notification workflows when timely communication of clinical determinations is required
Document clinical information completely, accurately, and in a timely manner
Consistently meet or exceed productivity, quality, and turnaround time expectations
Maintain a thorough understanding of accreditation and regulatory requirements and ensure utilization management decision-making and timeliness standards remain in compliance
Perform other duties as assigned

What you'll need:

Registered Nurse with active, unencumbered license in the state of residence
Experience developing member and provider correspondence within a health plan environment
Minimum of 3 years of clinical experience
Utilization Management experience required
Knowledge of NCQA and CMS standards and requirements
Thrive in a fast paced, self-directed environment
Understand how utilization management and case management programs integrate
Strong communication skills, able to effectively communicate in a positive and engaging manner and able to remain calm and professional under pressure
Comprehensive thinker/planner with understanding of clinical algorithms, care pathways, and how to effectively manage utilization across the care continuum to achieve optimal patient outcomes
Highly organized with excellent time management skills
Thrives on continuous process improvement, always actively seeking out practical solutions
Demonstrated ownership mentality with a willingness to take on new challenges and contribute beyond defined responsibilities when needed.
Bachelor's degree in Nursing
Utilization Review/Utilization Management experience
Proficiency in using a Mac
Experienced with G suite applications

Important to know about this role:

This is a 100% remote role, and requires robust internet speeds (above 50 megabytes/second), including the ability to utilize zoom meeting software and to stream video
The department is staffed seven days per week, 8am-8pm EST and shifts will be assigned based on need
This is a full time, 40 hour per week opportunity

Pay & Perks:

Fully remote opportunity with about 5% travel

Medical, dental, vision, life, disability insurance, and Employee Assistance Program

401K retirement plan with company match; flexible spending and health savings account

️Up to 184 hours (23 days) of PTO per year + company holidays

Up to 14 weeks of paid parental leave

Pet insurance

The salary range for this position is $31.00 - $35.00/hour; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.

Interview Process*:

Internet Speed Test

Behavioral Interview(s) with your Hiring Manager!

Subject to change

About Cohere Health:

Cohere Health's clinical intelligence platform and agentic AI-powered solutions connect health plans' strategic goals and providers' needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuum–including policy, prior authorization, payment accuracy, and more–the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.

With the acquisition of ZignaAI, we've further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.

Cohere Health's innovations continue to receive industry wide recognition. We've been named to the 2025 Inc. 5000 list and in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners.

The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.

We can't wait to learn more about you and meet you at Cohere Health!

Equal Opportunity Statement:

Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it's personal.

#LI-Remote

#BI-Remote

Quick Apply

Refine Your Search

Rn Director Case Management jobs

Clinical Review & Correspondence RN

Director of Nursing (DON) - Home Health

Director of Case Management

Registered Nurse (RN) Case Manager

Director of Nursing

Registered Nurse Care Coordinator

RN - Registered Nurse: Per Diem or Part Time - Skilled Nursing Rehab

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MDS Coordinator | RN

RN Patient Care Manager - Hospice

RN, Emergency Department Case Manager

Director of Nursing, Residential Division

Hospice Patient Care Manager - RN Required

RN Clinical Manager

Psychiatric Nurse Practitioner

RN/LPN Per Diem

Patient Care Management Coordinator

Director of Nursing

Hospice Field Nurse (RN)

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