USRN Case Manager (Utilization Management)

We are seeking a qualified and compassionate US Registered Nurse (USRN) Case Manager to join our healthcare team. In this role, you will assess, plan, coordinate, and monitor patient care to ensure high-quality, cost-effective outcomes.

You will collaborate with physicians, interdisciplinary teams, patients, and families to develop individualized care plans, facilitate care across the continuum, and support improved clinical outcomes while maintaining patient satisfaction.

• →Conduct comprehensive clinical, functional, psychosocial, and behavioral assessments
• →Develop, implement, and monitor individualized care plans with measurable goals
• →Coordinate care across providers, facilities, and community resources
• →Identify risks, barriers, and gaps in care and initiate appropriate interventions
• →Facilitate referrals to disease management and long-term care programs as needed
• →Maintain accurate and timely documentation of assessments, care plans, and follow-ups
• →Participate in Interdisciplinary Care Team (ICT) meetings and present case updates
• →Educate patients and families on care plans, self-management, and available resources
• →Ensure compliance with HIPAA, regulatory standards, and internal policies
• →Support continuity of care during transitions (e.g., hospital discharge, facility transfers)
• →Assist in audits, reporting, and quality improvement initiatives

• Active US Registered Nurse (RN) license
• Experience in case management, utilization review, or managed care preferred
• Strong understanding of managed care principles and healthcare systems
• Familiarity with clinical guidelines such as InterQual, Milliman, or similar is an advantage
• Excellent communication, coordination, and documentation skills
• Strong organizational skills with the ability to manage multiple cases
• Proficiency in Microsoft Office and clinical documentation systems

Industry standards applicable to the state depending on work experience and level of expertise.

US Pacific Standard Time (PST) - Monday to Friday - 9am to 6pm

We embrace the flexibility and convenience of a remote working environment, and you will collaborate with an international team while contributing to our growing business, all from the comfort of your home.

You will need to have some essential tools – a reliable computer and noise-canceling headset, a second monitor for enhanced productivity, and a stable internet connection. You’ll also be required to have a backup internet connection, ensuring that you’re well-equipped to complete your work seamlessly.

Don't miss out on this opportunity – apply now and become a valuable member of the Limitlessli team! If you're interested in what you have read, then we invite you to take the next step and submit your application.