salary: $42 - $43 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School
Responsibilities
In this role, you will:
- Manage and evaluate assigned cases (inpatient, outpatient, DME) for medical necessity based on policy and clinical guidelines
- Facilitate seamless care transitions by coordinating with providers, members, and internal teams
- Communicate clinical decisions, provide required notifications, and initiate peer-to-peer reviews when necessary
- Fully document case outcomes and interpret clinical data for further review
- Active RN license with at least 3 years of clinical experience or LPN license with at least 5 years
- Multistate/compact license (preferred)
- Excellent communication, time management, and documentation skills
- 100% remote, Monday–Friday schedule (no nights or weekends!)
- Opportunity to support patient health without direct clinical care
- Work with a supportive team focused on outcomes, efficiency, and integrity
Ready to make an impact? Apply today to take the next step in your care management career. Let’s help people together.
Skills
- Managed Care
- Patient Care Coordination
- Compliance Requirements
- Durable Medical Equipment
- Collaboration
Qualifications
- Years of experience: 2 years
- Experience level: Experienced
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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).
This posting is open for thirty (30) days.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.