Case Management Nurse

Registered Nurse (RN) – Case Manager

Pay Rate: $50- 54 per hour

Schedule: Day Shift | 5x8 (08:00 AM – 04:30 PM)

Hours: 40 hours per week

Contract Length: 13 weeks

Location Requirement: Local candidates only (within 60 miles of Washington, DC)

Job Summary

We are seeking an experienced Registered Nurse Case Manager to provide comprehensive care coordination and case management services. This role involves working with diverse patient populations, completing assessments, developing individualized care plans, and ensuring high‑quality, patient‑centered outcomes across the continuum of care.

The RN Case Manager will collaborate with interdisciplinary teams, physicians, and community resources while ensuring compliance with regulatory and quality standards.

Key Responsibilities

• Conduct comprehensive patient assessments and develop individualized care plans
• Perform ongoing care coordination and case management using EMR systems
• Communicate with patients (telephonically and in person) to monitor health status and care adherence
• Coordinate discharge planning and transitions across care settings
• Utilize InterQual and Milliman guidelines for clinical decision-making
• Collaborate with hospitals, providers, and community resources to optimize patient outcomes
• Address social determinants of health (SDOH) in care planning
• Ensure documentation meets NCQA and regulatory requirements
• Support prevention of hospital readmissions and emergency visits

Work Environment

• Mix of remote/office-based work with field visits (approximately 2 days/week)
• Business casual dress code
• Primarily telephonic patient engagement with occasional in-person visits
• No weekends or on-call requirements

Required Qualifications

• Active RN license (DC) – pending accepted at submission but must be active before start
• BLS Certification (AHA/ARC)
• Minimum 2 years of Case Management experience
• Experience in:
• Acute care or hospital settings
• Care coordination and discharge planning
• Admission criteria and utilization review
• InterQual and Milliman guidelines
• Strong knowledge of:
• CPT codes, DRG, HEDIS, NCQA
• OSHA, Joint Commission standards
• HIPAA and compliance regulations

Preferred Qualifications

• Previous Charge Nurse experience
• NCQA experience
• Experience with Medicaid or high-risk populations
• Familiarity with EMR systems (e.g., HealthEdge)

Patient Population

• High-risk and chronic conditions including:
• CHF, COPD, Asthma, Diabetes
• High-risk pregnancy and postpartum
• Behavioral health conditions
• Patients range from neonates to geriatrics

Additional Requirements

• Must be local (within 60-mile radius; driver’s license required for verification)
• Ability to manage a caseload of 50–160 patients
• Strong communication, organization, and documentation skills
• Must be comfortable working with vulnerable populations and multidisciplinary teams

*Offered pay rate will be based on education, experience, and healthcare credentials.

Pride Health provides a comprehensive benefits package, including medical, dental, and vision insurance, flexible spending accounts, company-paid life and long-term disability insurance, and optional supplemental life insurance for employees, spouses, and children. Additional perks include short-term disability, accident and critical illness coverage, identity theft protection, a 403b retirement plan, and tuition reimbursement of up to $4,000 annually for full-time employees.

Interested? Apply now!

About Pride Health

Pride Health is Pride Global's healthcare staffing branch, providing recruitment solutions for healthcare professionals and the industry at large since 2010.

As a minority-owned business that delivers exceptional service to its clients and candidates by capitalizing on diverse recruiting, account management, and staffing backgrounds, Pride Health's expert team provides tailored and swift sourcing solutions to help connect healthcare talent with their dream jobs. Our personalized approach within the industry shines through as we continue cultivating honest and open relationships with our network of healthcare professionals, creating an unparalleled environment of trust and loyalty.

Equal Employment Opportunity Statement

As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.