FREE ACCESS
5,000–10,000 jobs/day
See all jobs on JobTailor
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
About the role
Key responsibilities & impact- Review claims, prior auth requests, and ADT (admission/discharge/transfer) data to identify members who would benefit from case management
- Conduct clinical assessments and build individualized care plans with members
- Coordinate directly with PCPs, specialists, hospitals, and post-acute providers to ensure care plans are executed and gaps are closed
- Support members through complex episodes — new diagnoses, hospitalizations, transitions of care, and chronic condition management
- Partner with our utilization management workflows on medical necessity questions and appropriate level of care
- Help us build the playbook: contribute to protocols, escalation pathways, and the tooling we use to do this work well
- Document thoroughly and maintain compliance with applicable regulatory and accreditation standards
Requirements
What you’ll need- Active, unrestricted RN license; multi-state compact license strongly preferred
- 5+ years of clinical nursing experience, with relevant experience in case management, utilization management, care coordination, or discharge planning
- Comfort reading and interpreting claims data, prior auth criteria (MCG/InterQual), and clinical documentation
- Strong communication skills — you can hold your own with a skeptical specialist and also meet a member where they are
- Self-directed; you can run your panel without someone over your shoulder
- Comfort working in a fast-moving environment where processes are still being built
Benefits
Comp & perks- High ownership: You’ll get real responsibility from day one—our high-trust team empowers you to run with big problems and shape core parts of the company.
- Join an important mission: Your work directly influences how people access care and improves lives at scale.
- Growth & expansion: We’re moving fast, and as we grow, your scope will grow with us—new challenges, bigger opportunities, and rapid career velocity.
- Apply AI to a problem that matters: Instead of optimizing ads or cutting labor costs, you’ll use AI to fundamentally reimagine how people get healthcare.
- High pace, high collaboration: We operate with velocity, first-principles thinking, and a team that works closely, openly, and with ambition.
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical assessmentscase managementutilization managementcare coordinationdischarge planningclaims data interpretationprior authorization criteriaclinical documentation
Soft Skills
strong communicationself-directedadaptability
Certifications
active RN licensemulti-state compact license