Case Manager, RN

GlobalHealth, Inc.

Case Manager RN coordinating telephonic care for GlobalHealth, a Medicare Advantage HMO insurer. Advocating for high-risk members through assessments, care planning, provider coordination, and transitions of care.

Posted 8/5/2026full-timeRemote • Oklahoma • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in telephonic case management, patient advocacy, and care coordination for high-risk members, while ensuring compliance with HIPAA regulations and effective communication with care teams and patients.

Highest-signal resume keywords

Active Registered Nurse LicenseTelephonic Case ManagementManaged Care/Utilization Management ExperienceKnowledge of Disease ManagementAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Care PlanningOutcome MonitoringMedication ReconciliationHealth Risk Assessment (HRA)Individualized Care Plan (ICP) Creation

Soft Skills

Organizational SkillsMultitaskingTime ManagementEffective Communication

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft PowerPoint

Certifications & Qualifications

Active Multi-State RN License (Preferred)

Industry Keywords

Patient AdvocacyCrisis InterventionCommunity ResourcesProtected Health Information (PHI)HIPAA Compliance

About the role

Key responsibilities & impact

Conduct telephonic case management for complex, high-risk members, including needs identification and assessment, care planning and coordination, and outcome monitoring
Coordinate with providers to support holistic, healthy, beneficial outcomes
Maintain awareness of patient needs and condition changes through interdepartmental communication, network communication, and member outreach
Provide patient advocacy, support, quality-care assessment, and crisis intervention
Coordinate member services, including community resources, with other care-team members
Educate members and caregivers about conditions and self-management techniques
Initiate and participate in SNP MOC elements, including HRA completion, ICP creation, and ICT initiation
Complete transition-of-care activities, including post-discharge assessment, medication reconciliation/review, and ensuring follow-up-care access

Requirements

What you’ll need

High School or Equivalent education level
Active Registered Nurse license in the state of Oklahoma required
Active multi-state RN license preferred
Previous experience in managed care/utilization management preferred
Knowledge of current nursing processes, techniques, and established standards
Knowledge of disease management, medications, and community resources
Strong attention to detail and organizational, multitasking, and time-management skills
Ability to communicate clearly and effectively orally and in writing
Knowledge of Microsoft Word, Excel, and PowerPoint
Ability to work independently or as a team member
Reliable and secured internet connection
Ability to maintain confidentiality of business information and Protected Health Information in accordance with HIPAA and company policy
Ability to follow company privacy and security policies

Benefits

Comp & perks

Remote work environment
No travel required