Posted Jul 8, 2026

Remote Utilization Review RN Case Manager (Must have OH or Compact license)

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Job Title: Nurse Case Manager II (Remote / Telephonic) Location: Remote (Work from Home) — must be able to work 8:00 AM–5:00 PM Eastern (EST), Monday–Friday Job Type: Contract to hire Openings: 14 Interviews: Microsoft Teams Job Summary We’re hiring a Nurse Case Manager II (RN) for a fully remote, telephonic role. In this position, you’ll use clinical tools and data review to complete comprehensive member assessments, develop case plans, and coordinate services to support optimal, cost-effective outcomes while ensuring compliance with all regulatory and accreditation guidelines. This is a work-from-home role with no travel required. Schedule • Monday–Friday • 8:00 AM–5:00 PM EST • Must be able to work EST hours What You’ll Do • Conduct comprehensive assessments of referred members’ needs and eligibility • Determine the appropriate approach to case resolution and care/service planning • Apply and interpret applicable criteria, guidelines, and standardized case management plans • Coordinate internal and external programs/services to address member needs • Advocate for appropriate resources and services using a collaborative case management process • Document activities and manage cases in alignment with policy, procedures, and regulatory standards • Utilize case management and quality management processes to support compliance requirements Required Qualifications • Active, unrestricted RN license • Verified High School Diploma or GED • Ability to work independently in a remote/WFH environment • Must have a quiet, private workspace with no distractions due to HIPAA compliance Licensure note: • Candidates do not need to live in Ohio if they have a compact license • If you live in Ohio, you must have an active, unrestricted Ohio RN license or compact license Work-From-Home Requirements • Fully remote (never coming onsite) • No travel required • Must maintain HIPAA-compliant work environment (quiet/private workspace) Additional Details • Not an in-person, patient-facing role • Safety sensitive role How to Apply Apply now on ZipRecruiter. If selected, interviews will be conducted via Microsoft Teams.