RN Telehealth Full-time
Devoted Health

Bilingual (English/Spanish) Transitions of Care RN Case Manager

Devoted Health , US
$85,000 - $100,000 / year

Job Description

A bit about this role:
We want to help patients navigate the healthcare system in a better and safer way, and case management is critical to achieving this for our most vulnerable and complex patients. You'll be responsible for providing telephonic, short-term, interdisciplinary care management in the 30 days post-discharge for patients at high risk for readmission. You'll serve as an advocate for these patients, coordinating care and ensuring they have the necessary resources and support to achieve better health outcomes.

Our ideal RN is caring, compassionate, solution-oriented and enthusiastic about providing an outstanding experience for Devoted Health’s patients. They are committed to integrity, excellence, and empowering our patients to confidently navigate the healthcare system and live healthier lives. They are ready to innovate, adaptable to a continuously evolving startup environment, working with the whole Devoted family to create a revolution in how care is delivered.

Your Responsibilities and Impact will include:

Working with patients

  • Engaging with our newly discharged patients telephonically to understand their needs, supported by technology and data tools.

  • Conducting assessments to identify comorbid conditions, ED/hospitalization history, medications, psychosocial factors, and patient values and preferences.

  • Developing care plans in partnership with patients and their caregivers - problems, goals, interventions - while continuously evaluating the patient’s progress.

  • Explaining complicated medical terms in plain language.

  • Educating patients on their chronic conditions including teaching “red flags,” developing plans during an exacerbation, and identifying barriers to important care elements such as medication adherence.

  • Hearing the red flags and providing active care management to close the gaps.


Working with other providers and resources

  • Partnering with the TOC Nurse Practitioners and Physicians to ensure smooth handoffs, comprehensive follow-up, and coordinated care during the post-discharge period.

  • Referring patients to Devoted Medical when applicable and working closely on partnering for patient care.

  • Working closely with Devoted Community Guides (locally-based social workers) to identify community-based organizations to support our patients in meeting their goals.

  • Coordinating post-treatment care and DME needs.

  • Collaborating closely with our PCP partners, to coordinate care and deliver evidence based, effective, and accessible health care.


Required skills and experience:

  • An unrestricted Compact RN license obtained in the United States with the ability to secure other licensure states

  • 3-4 Years of Experience of RN Care Management/telephonic case management experience

  • Fully bilingual in English/Spanish

  • Working hours are Monday-Friday 10am-6:30pm ET or 10:30am-7:00pm ET. We are looking for candidates who are located in CT/MT/PT time zones.


Desired skills and experience:

  • Enthusiasm for working in a setting where meaningful time is spent on the phone with patients and/or their caregivers to build trust, educate, and coordinate care

  • Comfort and confidence working in an environment guided by performance and productivity metrics, with a focus on quality outcomes and patient experience

  • Health insurance experience, particularly Medicare Advantage

  • Prior Special Needs Plan, Population Health, or Transitions of Care case/care management experience

  • Clinical analytical thinking that allows you to apply your skills to the individual needs of each patient

  • Telephonic care/case management experience

Salary Range: $85,000 - $100,000 / year

The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

  • Employer sponsored health, dental and vision plan with low or no premium

  • Generous paid time off

  • $100 monthly mobile or internet stipend

  • Stock options for all employees

  • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

  • Parental leave program

  • 401K program

  • And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce.

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

Share this job

Share to FB Share to LinkedIn Share to Twitter

Related Jobs

Devoted Health

Clinical Guide Part A: Utilization Management Nurse

$85,000 - $95,000 / year
Job Description Schedule: The weekly schedule choice is either Monday - Friday 10am-7pm EST OR Tuesday - Saturday 9am-6pm EST A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient, behavioral health, and/or post-acute authorization review in alignment with CMS and Medicare Advantage regulations. Reviews medical records to evaluate the medical necessity and appropriateness of requested inpatient and/or post-acute services in accordance with established clinical criteria and CMS guidelines. Your Responsibilities and Impact will include: Review Medical Records: Conduct prospective (pre-service), concurrent, and retrospective utilization review to evaluate medical necessity, appropriate level of care (Inpatient vs. Observation), and post-acute services in accordance with established clinical criteria and CMS guidelines. Evaluate Treatment Plans: Assess the appropriateness, timing, and setting of requested services, ensuring alignment with medical necessity criteria and Medicare Advantage requirements. Recommend alternative levels of care when clinically appropriate. Inpatient & Behavioral Health Review: Perform initial, concurrent, and discharge reviews for inpatient and behavioral health admissions. Ensure admission status accuracy and regulatory compliance with CMS timeliness (TAT) standards. Post-Acute Review: Conduct initial authorization and concurrent review for post-acute services (SNF, LTACH, ARU, Home Health), evaluating ongoing medical necessity and appropriate length of stay. Issue NOMNC when coverage criteria are no longer met. Medical Director Collaboration: Refer cases that do not meet criteria to the Medical Director for secondary review and final determination. Prepare clinical summaries and coordinate peer-to-peer (P2P) discussions. Manage authorization reopen requests as appropriate. Resource Stewardship: Monitor utilization of inpatient and post-acute services to promote appropriate resource use while maintaining high-quality, member-centered care. Regulatory & Documentation Compliance: Maintain accurate, defensible documentation of all determinations. Ensure adherence to CMS regulations, Medicare Advantage requirements, and internal compliance standards. Required skills and experience: Unrestricted RN license with a minimum of 4 years of clinical experience. Minimum 3 years of Utilization Management or Inpatient UR experience within a health plan or hospital setting. Strong knowledge of CMS regulations and Medicare Advantage requirements. Experience preparing cases for Medical Director review Able to work in a fast paced environment that is constantly evolving. Desired skills and experience: Experience with AI/LLM Certified in InterQual #LI-Remote #LI-DS1 Salary Range: $85,000-$95,000 / year The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience. Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
Cheyenne Regional

Virtual Care Registered Nurse

Job Requirements A Day in the Life of a Virtual Care RN The Virtual Care Nurse works onsite at the virtual care hub and provides expert-level nursing care and clinical nursing support through virtual platforms to enhance patient care, improve workflow efficiency, and support bedside staff. This role leverages telehealth technology to deliver patient assessments, education, coordination, and clinical documentation in collaboration with interdisciplinary teams. The Virtual RN functions at the highest level of clinical proficiency, serving as a clinical resource, mentor, and leader within the interdisciplinary healthcare team. Why Work at Cheyenne Regional? Employer Sponsored Medical, Dental, and Vision Plans 403(b) and 457(b) retirement options with 4% employer match Life Insurance Short Term and Long-Term Disability Insurance Employer Sponsored Wellness Program Employee Assistance Program ANCC Magnet Hospital 21 PTO days per year (increases with tenure) Tuition Reimbursement Program Dedicated Loan Forgiveness Advisory Service Here is What You Will Be Doing: Conduct virtual patient assessments using video, audio, and remote monitoring tools, and complete all required electronic health record (EHR) admission documentation. Anticipate and respond to changes in patient condition through proactive surveillance and collaboration with bedside teams to support early identification and escalated warnings related to high-risk patient populations. Assist with patient admissions, discharge education, and medication reconciliation Provide real-time patient education and care plan reinforcement Support chronic disease management and follow-up care while guiding patients through lifestyle habits and medication compliance for illnesses such as COPD, CHF, diabetes, and hypertension. Assist with dual-nurse medication verifications, medication reconciliation and real-time checklist tracking. Partner with bedside nurses, physicians, and interdisciplinary teams to deliver coordinated patient care and manage data communication during critical events. Review discharge instructions, confirm patient readiness, and lead video-based discharge education for patients and families. Provide real-time support, guidance, and clinical recommendations to onsite staff. Assist with care transitions and referrals across care settings Ensure continuity of care through timely communication and documentation Serve as a clinical expert and mentor, coaching and supporting nurses in clinical and professional practice Adhere to all regulatory, compliance, and telehealth standards Participate in quality improvement initiatives and data tracking Desired Skills: Ability to make fast, accurate clinical decisions from a distance. Ability to balance multiple digital chat streams, video queues, an documentation tasks at once. Ability to establish trust, rapport and promote empathy through a screen. Ability to provide clear, concise instructions via various technology platforms. Ability to operate cameras, monitors, and specialized remote patient monitoring hardware. Proficient skills in EPIC and secure communication networks. Advanced knowledge of triage systems, admission and discharge criteria, escalation pathways and chronic disease management. Here is What You Need: Associate's degree or higher from an accredited school of nursing Two (2) or more years of experience in adult critical care, emergency services, or telemetry License (must meet one of the following): Current Wyoming Registered Nurse (RN) License from the Wyoming State Board of Nursing Current enhanced Nurse Licensure (eNLC) 14 Days: Cheyenne Regional AHA RQI within fourteen (14) calendar days of start date Nice to Have: Bachelor's degree in nursing (BSN) Critical Care Nurse (CCRN) certification Certified Emergency Nurse (CEN) certification About Cheyenne Regional: Cheyenne Regional Medical Center was founded in 1867 as a tent hospital by the Union Pacific Railroad to treat workers injured while building the transcontinental railroad. Today, we are the largest hospital in the state of Wyoming, employing over 2,000 people, and treating over 350,000+ patients from southeastern Wyoming, western Nebraska, and northern Colorado. We pride ourselves on patient and employee experience by living our core values of I ntegrity, Cari n g, Compa s sion, Res p ect, Serv i ce, Teamwo r k and E xcellence to great health. Our team makes a difference every day by providing trusted healthcare expertise through a passionate and I.N.S.P.I.R.E.(ing) approach with a personal touch. By living our values, we aim to achieve our goal of becoming a 5-star rated hospital, providing critical support and resources to our community and the greater region we serve. If you are eager to make a difference and passionate about healthcare, we encourage you to apply today!
Texas Children's Hospital

Utilization Mgmt Clinical RN

Job Description We’re searching for a Utilization Management Clinical Registered Nurse, someone who works well in a fast-paced setting. In this position, you’ll be responsible for providing precertification of inpatient hospitalizations and all outpatient procedures and services requiring authorization, and performing telephonic and/or concurrent review of inpatient hospitalizations and extended courses of outpatient treatment. Think you’ve got what it takes? Job Duties & Responsibilities Analyzes unique situation of request, identifying appropriate guideline and regulatory requirements for each request Applies clinical decision making to assessment of clinical acuity and appropriateness of suggested treatment/services Creates a case summary evaluation for requests failing medical necessity criteria, and has collaborative discussion with the medical director or designee for review and disposition Researches clinical guidelines for potential investigative service requests, researches weekly changes to Medicaid manual to assure coverage determinations, and maintains currency of clinical guideline elements Ensures the timeliness of all denial letters within the regulations mandated Creates communication pieces to providers, which meet accrediting and regulatory guidelines for clinical content and readability levels describing decision making rationale for service requests and notifies providers through written correspondence Collaborates with all disciplines within the health plan to meet goals and objectives meeting with contracting and provider relations on routine basis Screens, identifies, and refers potential members to case management and evaluation for programs or coverage Identifies potential quality of care issues, and/or fraud and abuse, and refers to appropriate department As part of our commitment to maintaining a safe and healthy workplace, all successful candidates will be required to undergo respiratory fit testing in compliance with occupational health and safety standards. Skills & Requirements Diploma in nursing required or Associates degree in nursing or an associate’s degree in a related field accepted by the Texas Board of Nursing for the purposes of obtaining and maintaining an RN license required or Bachelor's degree in nursing preferred RN - Lic-Registered Nurses by Texas Board of Nursing or Nursing Licensure Compact required 3 years of nursing experience required About Us Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
UnitedHealthcare

Clinical Appeals RN - Remote - M-F working alternating Saturdays

$28.94 - $51.63 / hour
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Clinical Appeals RN is responsible for providing expertise in clinical appeals and grievances (analyzing, reviewing, and evaluating appeals and grievances), and acting as a Clinical Interface Liaison (clinical problem solver with facilities, providers, carriers, resolution of issues concerning members, benefits, program definition and clarification). You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Please note this team has a schedule as follows - M-F, 8:00- 4:30 in their time zone and alternating Saturdays (2 per month with a weekday off when working a Saturday) . Primary Responsibilities Review medical records and verify if the requested service meets criteria Review pre-service appeals for clinical eligibility for coverage as prescribed by the Plan benefits Review and interpret Plan language Coordinate reviews with the Medical Director Utilize clinical guidelines and criteria Accurately documenting determinations Adherence to all confidentiality regulations and agreements Hours M-F 8a-5p with alternating Saturdays Comfortable working mandatory overtime You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Active, unrestricted RN license in state of residence 2+ years of clinical experience as an RN, including in an acute, inpatient hospital setting Proficiency in Microsoft Office, Word, Outlook, and Internet applications Available M-F, 8:00- 4:30 in their time zone and alternating Saturdays (2 per month with a weekday off when working a Saturday) Preferred Qualifications Bachelor of Science in Nursing 1+ years of experience using MCG and/or Medicare criteria 1+ years of Utilization Management, pre-authorization, concurrent review or appeals experience Appeals experience Proven excellent communication, interpersonal, problem-solving, and analytical skills All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits re subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline : This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Northwell Health

Registered Nurse (RN) - Neuro Tele-Medicine

$57 / hour
194461 Job Description Performs an age specific plan of care for designated group of patients using the nursing process of assessment, diagnosis, outcome identification, planning, implementation, and evaluation of patient care. Collaborates with physicians and other health team members in coordinating and implementing procedures and treatments. Uses leadership skills/clinical judgment in coordinating patient care and directing/delegating activities of the patient care unit team. Job Responsibility Conducts patient interview, explains policies and procedures to patient/ significant others, reviews patient’s chart and answers questions correctly and courteously; assesses gastrointestinal, cardiovascular, respiratory, renal and neurological health status; determines mobility, sensory deficits, prostheses use, and skin condition and adjusts plan of care, as appropriate, assesses level of pain and pain management; communicates/documents patient’s physiologic health status and plan of care. Assesses patient’s psychosocial health status; elicits perception of medical/nursing care and the expectation of care; determines coping mechanism, knowledge level, and ability to comprehend; identifies cultural/ethnic requirements to reduce anxiety and ensure patient satisfaction; communicates and documents psychological status and care plan of support groups, counseling services, and social services. Identifies patient outcome; develops criteria for measurement of patient outcomes; identifies actual/potential patient problems; identifies patient’s need for teaching based on psychosocial and developmental assessment.Develops patient outcome statement (s) and establishes individualized patient goals. Identifies care activities and establishes the priorities necessary to achieve expected outcome; coordinates the cost-effective use of supplies, equipment and medication to achieve expected outcome; documents the plan of care and collaborates with physicians and other health team members. Implements the plan of care; maintains constant vigilance over patients care to ensure that safety precautions/needs are followed (side rails up, call lights and bedside stand within reach, etc.; exercises professional skills related to the plan of care; reassesses patients as needed and appropriately revises plan of care; correctly administers prescribed treatments; correctly uses equipment necessary for patient care; provides emotional support to patient and significant other; applies scientific principles in performing procedures; carries them out safely, timely and efficiently; makes accurate observations of patient’s conditions during treatments/procedures; reports and records same as appropriate; keeps accurate documentation of patient’s treatment, activity and condition, as well as patient’s responses to medical and nursing interventions; uses appropriate methods of documentation according to departmental policy; acts rapidly and effectively during any emergency situation, managing self, patients and other employees; provides a calm, quiet, restful atmosphere; communicates effectively with the patient’s family or caretakers; participates in planning for discharge and coordinates referrals, as appropriate; provides discharge instructions to patient and significant other; evaluates care provided for patient outcome. Demonstrates ability to measure effectiveness of care provided and documents same; performs variance analysis related to outcome data for performance improvement; designs, implements, and evaluates systems to improve care in unit; keeps accurate documentation of patient’s treatment, activity and condition; uses appropriate methods of documentation according to departmental policy. Collaborates with other care team members in planning and carrying out treatment regimen; provides direction to other members of the care team; collaborates with the appropriate physician on patient’s plan of care. Accurately interprets and implements treatment regimen as prescribed by the Physician; assists the Physician during treatments and/or diagnostic procedures; keeps Patient Care Manager/designee and/or physician, abreast of changes in patient’s condition and/or treatments, as appropriate; uses clinical judgment in delegating assignments in providing patient care, and ensures that assignments are completed in a timely fashion. Performs grade I-IV Decubitus Care; performs preventive skin care measures; applies simple dressings, maintaining principles of aseptic technique; applies warm and cold compresses, consistent with facility procedure; performs irrigations, consistent with Facility procedure; performs other procedures related to skin care, as necessary. Administers medications correctly and safely; correctly identifies medication in terms of action, dosage, side effects, and implications for the patient; meets standard on medication administration examination; demonstrates preparation of local solutions.Administers and documents medication correctly; educates patients and significant others related to drug and food interactions; educates patients and significant others related to drug and food interactions. Participates in patient and family education; provides patient with an explanation of his/her condition as indicated; communicates assessment data in an orderly fashion by recording, updating and verbalizing pertinent information to care team members and to appropriate agencies; recognizes and utilizes health teaching opportunities and resources /materials available for this teaching; provides for early discharge planning and appropriate referrals for post-hospital care; evaluates the effectiveness of teaching by feedback from patient/ family and documents same. Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Job Qualification Graduate from an accredited School of Nursing, required. Bachelor’s Degree in Nursing, preferred. Must be enrolled in an accredited BSN program within two (2) years and obtain a BSN Degree within five (5) years of job entry date. Current License to practice as a Registered Professional Nurse in New York State, required. Specialized certifications, as needed. Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).