Care Manager, RN

Peak Health

Care Manager RN at Peak Health, responding to high risk members and managing healthcare resources effectively. Collaborating with a medical management team to improve community health outcomes.

Posted 7/8/2026full-timeMorgantown • Virginia, West Virginia • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Identify and connect high risk members to appropriate resources and programs to achieve optimal quality and financial outcomes.
Manage and triage self-referrals and identify high risk members through HRA, reporting and admissions data.
Audit patient charts of delegated case management programs to meet accreditation standards.
Connect members with in-network providers and resources.
Assist in utilization management reviews and ensure quality standards in auditing processes.
Participate in case management and quality committees.

Requirements

What you’ll need

Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC)
Three (3) years of healthcare clinical experience.
Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN); Currently enrolled in a BSN program and BSN completion within three (3) years of hire.
Management of Medicare and/or Medicaid populations.
Two (2) years Care Management experience.

Benefits

Comp & perks

Standard office environment

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

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

Hard Skills & Tools

Patient Chart AuditingQuality Standards AuditingHigh Risk Member IdentificationData ReportingSelf-Referral Management

Soft Skills

CommunicationCollaborationProblem-Solving