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Case Manager (Full Remote)

New York City, NY

A leading national Managed Care Organization is seeking a Case Manager for their location in New York.

Remote employees must live in New York Tri-state region



  • Registered Nursing Degree required; Bachelor’s Degree in Nursing preferred; Case Management Certificate preferred.


  • Minimum of 2 years of Medical Case Management experience.
  • Minimum of 1 year of Public Health experience.
  • Minimum of 2 years of critical care and/or med-surg experience.
  • Knowledge of applicable state, federal, and third-party regulations and standards (Background in discharge planning and home health).

Special Skills or Knowledge:

  • Knowledge of a variety of clinical areas of medical treatment.
  • Familiarity with hospital/patient care facilities, current practices, procedures, acceptable medical treatment, and diagnoses.
  • Ability to learn company policies and procedures related to hospital authorization/denials, physician review, appeals, etc.
  • Ability to apply established guidelines and regulations to specific and individual situations.
  • Strong oral and written communication skills to ensure accurate transfer of information and build rapport.
  • Proficiency in establishing and maintaining a variety of records necessary for providing complete information and documentation for relevant medical determinations.
  • Ability to establish and maintain effective work relationships with various stakeholders.
  • Proficiency with PC-based computer systems and ability to learn new information systems and software.
  • Excellent organizational skills.


  • Valid New York State Registered Nursing license (BSN preferred).
  • Capability of transporting self to various locations. If operating a motor vehicle, must have a valid New York Driver’s license; if using own vehicle, must have proof of insurance coverage that at least meets current State minimum requirements.
  • Certified Case Manager (CCM) Certification preferred.

This is an open-ended assignment and a great opportunity to join a national organization.

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