Top 609 Telephonic disease management nurse Jobs

Case Management Nurse - Oncology or Transplant Experience
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Case Management Nurse - Oncology or Transplant Experience
Innovative Care Management, Inc. —Iowa
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RN Clinical Communications Coordinator - Transplant
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Nurse Care Manager
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Registered Nurse Care Manager, VBC
Somatus, Inc. —San Antonio, TX
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Upward Health —Lake Charles, LA
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Case Management Nurse - Oncology or Transplant Experience

Innovative Care Management, Inc.
Idaho

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Job Details

Full-time
9 days ago

Benefits

Health insurance

Qualifications

Care plan evaluation
Nursing
RN License
Maintaining patient confidentiality
Experience working with individuals with chronic illnesses
HIPAA
Patient advocacy
Case management
Utilization management
Bachelor of Science in Nursing
Resource utilization in healthcare
Health information regulatory compliance
Disease state management
Transplant care
Oncology
Associate Degree in Nursing

Full Job Description

About Innovative Care Management

In an increasingly complex healthcare environment, ICM remains focused on something essential: putting people at the center of every decision. We are dedicated to ensuring that members and health plans feel genuinely seen, heard, and supported throughout their care journey.

We serve clients nationwide with a values-driven approach that blends compassion, clinical expertise, and operational excellence. Our core values: Kindness, Personal Responsibility, a Can-Do Attitude, and Humble Confidence, shape how we work, how we lead, and how we care for those we serve.

As we grow, we welcome individuals who share our belief that healthcare should be effective, compassionate, and truly centered on people.

About The Role

The Case Manager Nurse plays a critical role in supporting members with complex medical conditions by providing proactive, telephonic case management grounded in a whole-person approach. This position will primarily support members with oncology and transplant-related needs, helping patients navigate some of the most complex healthcare journeys while improving care coordination, outcomes, and the overall member experience.

As a trusted clinical resource, you'll partner closely with members, providers, transplant centers, oncology teams, and health plans to assess needs, develop individualized care plans, and advocate for appropriate, cost-effective services. In addition to case management responsibilities, you'll also support utilization review activities when needed, contributing to timely medical necessity determinations and continuity of care.

This position is ideal for an experienced RN with a background in oncology and transplant nursing who brings strong clinical judgment, exceptional communication skills, and a passion for supporting patients through complex episodes of care in a collaborative, remote environment.

This is a fully remote role. Candidates must reside in Iowa, Arizona, or Idaho.

Schedule: This position works four 10-hour shifts per week and must be able to support ICM’s standard operating hours of 8:00 AM–5:00 PM Pacific Time. Specific shift times may vary based on business needs and the candidate’s time zone. For example, a candidate residing in Iowa may have a shift that begins earlier in Central Time, such as 7:00 AM or 8:00 AM CT, depending on coverage needs.

What You'll Do

Patient Identification & Assessment

Identify members who would benefit from case management using claims data, referrals, and clinical records
Review referrals for clinical appropriateness using sound judgment and program parameters
Conduct comprehensive assessments of medical, behavioral, and social needs using a whole-person approach

Care Planning & Coordination

Develop individualized care plans based on patient needs, barriers, and goals
Coordinate care across the continuum, including primary care, oncology providers, transplant teams, specialists, behavioral health, and community-based resources
Facilitate clear communication between patients, providers, caregivers, and health plans to support safe transitions of care and adherence to treatment plans

Clinical Case Management & Advocacy

Provide telephonic case management for high-utilization patients with complex or chronic conditions
Use best practices in chronic disease management, motivational interviewing, and patient education
Advocate for timely, appropriate, and cost-effective care while balancing clinical judgment with plan guidelines
Support patients in navigating healthcare systems and overcoming barriers to care

Utilization Review & Medical Decision-Making

Evaluate precertification requests using evidence-based criteria and plan-specific guidelines
Review ongoing inpatient stays and make length-of-stay determinations as appropriate
Partner with Appeals & Denials and/or in-house providers to support complex clinical decisions

Documentation, Reporting & Compliance

Document all assessments, interventions, communications, and determinations thoroughly and accurately in ICM systems
Provide client-facing reports summarizing interventions, outcomes, and estimated cost savings
Ensure compliance with internal policies, regulatory requirements, and HIPAA standards

Collaboration, Leadership & Continuous Improvement

Partner with other clinical teams across ICM to remove care barriers and improve patient outcomes
Serve as a senior clinical resource, contributing to program development, cross-training, and process improvement
Stay current on best practices, regulations, and clinical guidelines related to case management
Participate in training, quality assurance initiatives, and professional development

What You Bring

Required

Active, unrestricted Registered Nurse (RN) license in good standing
Associate’s or Bachelor’s degree in Nursing
5+ years of clinical nursing experience
Current or recent oncology nursing experience
Current or recent transplant nursing experience (solid organ, living donor, HSCT/BMT, or tissue transplant)
Strong knowledge of chronic disease management, utilization management, and social determinants of health
Experience managing complex, high-utilization patient populations
Excellent written and verbal communication skills with empathy, professionalism, and emotional intelligence
Strong organizational skills with the ability to manage multiple priorities independently
Sound clinical judgment and confidence navigating complex or sensitive situations
Comfort working independently in a remote environment with strong accountability and follow-through
Ability to manage confidential information in compliance with HIPAA
Must reside in Iowa, Arizona, or Idaho
Ability to work four 10-hour shifts per week and support coverage during ICM’s standard operating hours of 8:00 AM–5:00 PM Pacific Time

Even Better If You Have

Case management or utilization certifications (e.g., CCM, CPUR, CPHM)
Certified Clinical Transplant Nurse (CCTN) credential
Certification through the American Association of Transplant Management (AATM)
Oncology Certified Nurse certification (OCN).
Experience in case management

Experience in a TPA or self-funded health plan environment
Knowledge of health insurance regulations and utilization management processes
Experience using medical necessity criteria and utilization review tools
Experience with EMRs and care management platforms
Multi-state licensure

Work Location: Remote

Apply Now

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