Guide Healthcare

RN Case Manager, Complex Pediatric Specialty

Guide Healthcare

full-time

Posted on:

Location Type: Remote

Location: United States

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Salary

💰 $80,000 - $83,000 per year

About the role

  • Conducting in-depth telephonic assessments to understand each patient’s medical, psychosocial, and social needs.
  • Reviewing and updating medical histories—including medications, chronic conditions, and preventive care.
  • Developing individualized care plans and guiding patients through their treatment goals and care options.
  • Providing empathetic, evidence-based education on chronic disease management and preventive health.
  • Monitoring progress by phone, adjusting care plans, and ensuring patients stay connected to their providers.
  • Completing Medicare Annual Wellness Visits (AWVs) via telehealth under physician supervision.
  • Partnering with Healthguides who support non-clinical needs like scheduling, transportation, food assistance, and SDOH resources.
  • Performing proactive outreach and timely follow-ups to maintain continuity of care and patient engagement.
  • Advocating for patients, helping them access the right resources at the right time.
  • Documenting clearly and accurately in the EHR and care-management systems during and after calls.
  • Supporting quality outcomes (HEDIS, NCQA) by coordinating preventive services and managing chronic conditions.
  • Participating in virtual meetings, ongoing education, and clinical training to stay current with care standards.
  • Using multiple communication methods (phone, text, patient portals, email, AI-supported tools) to reach high-risk patients.
  • Collaborating in AI-driven outreach programs that help connect with vulnerable populations.
  • Protecting patient privacy in a secure, private home workspace.
  • Performing additional responsibilities as needed to support patients and the care team.

Requirements

  • Active Compact Registered Nurse license in good standing is required.
  • 3+ years of RN Case Management experience, preferably in outpatient or ambulatory care.
  • 3+ years of RN Case Management experience, specifically focused on complex pediatric cases.
  • Strong critical-thinking and problem-solving skills to anticipate barriers and drive care forward.
  • Ability to work independently, manage multiple priorities, and make sound clinical decisions remotely.
  • Outstanding communication—warm, clear, confident, and patient-focused.
  • Excellent telephonic interviewing skills and the ability to document accurately in real time.
  • High comfort level with technology: EMRs, care-management systems, multi-screen workflow, Microsoft Office, and telecommunication tools.
  • Understanding of accreditation and quality standards (NCQA, HEDIS).
  • A quiet, private home office suitable for patient calls and handling PHI.
  • Alignment with Guidehealth policies, clinical protocols, and compliance standards.
Benefits
  • Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
  • Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.
  • Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
  • Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.
  • Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
  • Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.
  • Support Your New Family: Guidehealth offers paid parental leave to give you the time you need.
  • Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.

Applicant Tracking System Keywords

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

Hard skills
RN Case Managementtelephonic assessmentschronic disease managementpreventive healthcare plansEHR documentationpatient engagementMedicare Annual Wellness Visitsclinical decision-makingtelehealth
Soft skills
critical-thinkingproblem-solvingindependent workcommunicationinterviewing skillspatient advocacyempathytime managementcollaborationadaptability
Certifications
Compact Registered Nurse license