Registered Nurse, Care Manager

Job not on LinkedIn

🔥 7 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 12%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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OneVeracity

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

OneVeracity is a broker-led healthcare cost-control company that partners with self-funded employers and brokers to deliver clarity, defensible reporting, and measurable savings. Their offerings include health plan administration and risk solutions, pharmacy strategies (VeracityRx) to stabilize specialty drug spend, care navigation programs, and onsite health centers—backed by dedicated account management, member support, and reporting. OneVeracity emphasizes integrated, single-partner coordination (acting as a hub/T PA and pharmacy partner), highlights measurable outcomes (360+ employer clients, ~94% retention, typical savings of 20–30% when aligned), and targets brokers and employers to simplify plan administration, reduce total cost of care, and improve renewal control.

📋 Description

• Conduct case management activities in accordance with Veracity Benefits policies and procedures • Manage complex, acute assigned cases to ensure quality, cost-effective health care services and optimal health outcomes • Coordinate and facilitate member care through assessment, evaluation, planning and implementation via telephonic case management activities • Communicate member needs to care team members and follow up accordingly • Assist with discharge planning when necessary • Collaborate with members, family members, physicians, and other care team members • Provide education and support for managing conditions and symptoms • Guide members in navigating the healthcare system and understanding plan benefits and available resources • Coordinate access to providers, community resources, and health benefits • Deliver interventions to avoid poor health outcomes, reduce readmissions and unnecessary treatment, manage transitions of care, and improve wellness • Maintain regular contact with members and care team members • Document care management activities, medical record reviews, communications, service coordination, resource linkage, advocacy, education, and negotiations • Assess and summarize member health status, prognosis, treatment plan, and anticipated costs • Research and provide cost-savings resources including alternative funding programs, manufacturer assistance, and grants • Advocate for the appropriate level of care and address barriers and psychosocial issues • Develop plans of care including interventions and projected cost savings • Communicate patient-safety threats to the Medical Director, Physician Advisor, or leadership • Participate in clinical rounds, staff meetings, and committee meetings • Provide feedback on care management program services, procedures, and resource needs • Advocate for access to quality, cost-effective care and treatment goals • Negotiate discounts or reduced charges for high-cost or out-of-network providers • Maintain HIPAA confidentiality • Coordinate with stop-loss/reinsurance carriers on health status, prognosis, and anticipated costs for employer group renewals

🎯 Requirements

• Registered Nurse with a clear, active and unrestricted license in state of residence • Multi-state Compact RN license preferred (required upon hire) • A Bachelors (or higher) degree in a health-related field • Certification in Case Management (CCM) or equivalent preferred (required within one year of hire) • Minimum of five (5) years direct patient care experience in an acute care or hospital based setting • Three (3) to five (5) years of case management or related experience • Experience working in a managed care setting preferred • Strong Problem-solving skills are essential • Excellent typing, computer and documentation skills • Ability to coordinate and communicate with a multidisciplinary team (internal and external)

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