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Remote Telephonic Nurse Case Manager Jobs in Delaware

Pharmacy Careers

MTM Pharmacist

Wilmington, DE · Remote

$56.50 - $68/hr

... remote MTM services. Key Responsibilities: * Conduct telephonic or video MTM sessions for Medicare ... Prior MTM, chronic disease management, or ambulatory care experience. * Ability to connect and ...

Pharmacy Careers

MTM Pharmacist

Wilmington, DE · Remote

$56.50 - $68/hr

... remote MTM services. Key Responsibilities: * Conduct telephonic or video MTM sessions for Medicare ... Prior MTM, chronic disease management, or ambulatory care experience. * Ability to connect and ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Newark, DE · On-site +1

$56 - $68.25/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Dover, DE · On-site +1

$57.25 - $69.75/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Agile Legal

Senior Litigation Paralegal

Middletown, DE · Remote

$35 - $45/hr

This remote position requires exceptional time management, responsiveness, and the ability to ... Organizing and maintaining case files and documents, ensuring all materials are up-to-date and ...

Agile Legal

Senior Litigation Paralegal

Middletown, DE · On-site +1

$35 - $45/hr

This remote position requires exceptional time management, responsiveness, and the ability to ... Organizing and maintaining case files and documents, ensuring all materials are up-to-date and ...

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How much do remote telephonic nurse case manager jobs pay per hour?

As of May 28, 2026, the average hourly pay for remote telephonic nurse case manager in Delaware is $36.52, according to ZipRecruiter salary data. Most workers in this role earn between $29.62 and $38.51 per hour, depending on experience, location, and employer.

What Does a Remote Telephonic Nurse Case Manager Do?

Telephonic nurse case managers are medical professionals who coordinate all aspects of patient care for high-risk individuals. As a remote telephonic nurse case manager, you work primarily from home. Using telephone communications, you evaluate each client while directing treatment plans, discuss claims, benefits, and eligibility, and manage resources. Your responsibilities include overseeing outstanding patient care while working alongside patients, their families, and other medical professionals. Other duties may include collaborating with insurance companies, social workers, and supply managers. You may also address the legal and ethical aspects of patient care.

What are the key skills and qualifications needed to thrive as a Remote Telephonic Nurse Case Manager, and why are they important?

To thrive as a Remote Telephonic Nurse Case Manager, you need strong clinical knowledge, case management experience, and a current RN license, often supported by a BSN degree. Familiarity with case management software, telehealth platforms, and relevant certifications such as CCM or ACM is typically expected. Exceptional communication, critical thinking, and organizational skills are crucial for building rapport with patients and coordinating care remotely. These competencies ensure effective patient management, improved health outcomes, and efficient care coordination in a virtual environment.

What are some common challenges faced by Remote Telephonic Nurse Case Managers and how can they be addressed?

Remote Telephonic Nurse Case Managers often encounter challenges such as building rapport with patients without face-to-face interaction and managing caseloads across different time zones. To address these, strong communication skills, effective time management, and the use of structured assessment tools are essential. Regular collaboration with interdisciplinary teams via virtual meetings and leveraging technology platforms for documentation can also help streamline workflows and enhance patient outcomes.

What is a Remote Telephonic Nurse Case Manager?

A Remote Telephonic Nurse Case Manager is a registered nurse who works from a remote location, providing case management services to patients primarily over the phone. They coordinate care, assess patient needs, develop care plans, and facilitate communication between patients, healthcare providers, and insurance companies. Their goal is to help patients achieve optimal health outcomes while ensuring efficient use of resources. This role is common in health insurance, workers’ compensation, and managed care organizations.

What is the difference between Remote Telephonic Nurse Case Manager vs Remote Telephonic Utilization Review Nurse?

AspectRemote Telephonic Nurse Case ManagerRemote Telephonic Utilization Review Nurse
CredentialsRN license, case management certificationRN license, utilization review certification
Work EnvironmentPatient advocacy, care coordinationInsurance review, medical necessity assessment
Employer & IndustryHealthcare providers, case management companiesInsurance companies, health plans

Both roles require RN licensure and involve remote work, but the Nurse Case Manager focuses on coordinating patient care, while the Utilization Review Nurse assesses medical necessity for services. They serve different functions within healthcare and insurance industries, though both are vital for patient and cost management.

More about Remote Telephonic Nurse Case Manager jobs
What are popular job titles related to Remote Telephonic Nurse Case Manager jobs in Delaware? For Remote Telephonic Nurse Case Manager jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Remote Telephonic Nurse Case Manager jobs in Delaware look for? The top searched job categories for Remote Telephonic Nurse Case Manager jobs in Delaware are:
What cities in Delaware are hiring for Remote Telephonic Nurse Case Manager jobs? Cities in Delaware with the most Remote Telephonic Nurse Case Manager job openings:
Remote Telephonic Nurse Case Manager jobs near you
Case Manager Long-term Care - Delaware (Kent, Sussex, New Castle)

Case Manager Long-term Care - Delaware (Kent, Sussex, New Castle)

Highmark Health

New Castle, DE • On-site, Remote

Full-time

Posted 9 days ago

Highmark Health rating

7.8

Company rating: 7.8 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

Job description

Company :
Highmark Inc.Job Description :
JOB SUMMARY
This job serves as the single point of contact for members to coordinate all of the member's care needs across the various service delivery systems and community supports. This is a full-time community-based position requiring frequent travel within the assigned territory in DE. A significant portion of this role involves working directly with members in their homes and also requires providing case management services within nursing facility settings. The incumbent will travel to members' homes, nursing facilities, and other community-based settings for individuals enrolled in DSHP Plus LTSS and DSNP.
ESSENTIAL RESPONSIBILITIES
  • Conduct regular in-home and nursing facility visits: Travel to members' homes, nursing facilities, and other community-based settings to complete face to face needs assessments with subsequent telephonic contact with the member in accordance with state and national guidelines, policies, procedures, and protocols. This includes actively working within the nursing facility environment and participating in NF care plan conferences to ensure member needs are met.
  • Assess, plan, coordinate, implement and evaluate care for eligible members with chronic and complex health care, social service and custodial needs in a nursing facility or home and community-based care setting.
  • Coordinate care across the continuum of services and assisting members physical, behavioral, long term services and supports (LTSS), social, and psychosocial needs in the safest, least restrictive way possible while considering the most cost-effective way to address those needs. This includes ensuring appropriate care transitions between home, community, and community-based care settings.
  • Authorize LTSS services based upon completion of a comprehensive needs assessment. Coordinate HCBS services, Medicaid and DSNP benefits and assess appropriateness of care and services in community.
  • Facilitate transitions to alternate care settings such as hospital to home, nursing facility to community setting using an integrated care team to address the member's specific needs.
  • Educate members or caregivers regarding health care needs, available benefits, resources and services including available options for long term care community or facility-based service delivery.
  • Provide education, resources, and assistance to help members achieve goals as outlined in their plan of care and to overcome obstacles to achieving optimal care in the least restrictive environment.
  • Develop individualized care plans in conjunction with members or caregivers to identify services to meet the member's specific needs, and goals.
  • Identify resources needed for a fully integrated care coordination approach including facilitating referrals to special programs such as Disease/Chronic Condition Management, Behavioral Health, and Complex Case Management.
  • Collaborate with the member's health care and service delivery team including the physical, behavioral health providers, ICT, and discharge planners, to coordinate the care needs and community resources for the member to maintain the member in the least restrictive safe environment possible.
  • Assist members in developing, implementing and amending a back-up plan for gaps in provider coverage.
  • Ensure approved support services are being provided as outlined in the plan of care.
  • Evaluate the effectiveness of the service plan and making appropriate revisions as needed in accordance with per policy & procedures and state contractual requirements.
  • Assist members in overcoming obstacles to optimal care through connection with community resources, including communicating with providers and formulating an appropriate action plan.
  • Document all case management services and intervention in the electronic health record.
  • Adhere to all company, State and Federal requirements related to privacy practices, HIPAA, and quality performance standards.
  • Perform other duties as assigned/requested.

QUALIFICATIONS
Required
  • Bachelor's degree in Social Work or in health, human, or education services and 3 years of experience in long-term care, home health, hospice, public health, or assisted living OR
  • Master's degree in Social Work or in health, human, or education services and 1 year of experience in long-term care, home health, hospice, public health, or assisted living OR
  • Current State RN or LPN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) and 2 years of experience in long-term care, home health, hospice, public health, or assisted living OR
  • A high school degree or equivalent and three years of qualifying experience with case management of the aged, including management of behavioral health conditions, or persons with physical or developmental disabilities, or HIV/AIDS population.

Substitutions
  • None

Preferred
  • One year in home clinical or case management experience
  • Certified Case Manager (CCM)
  • Licensed Bachelors Social Worker (LBSW)
  • Licensed Masters Social Worker (LMSW)
  • Licensed Clinical Social Worker (LCSW)
  • Experience working with HIV/AIDS population
  • Experience working with behavioral health population
  • Experience working with developmental disabilities population
  • Medicare and Medicaid experience
  • Managed care experience

SKILLS
  • Working flexible hours to meet member's needs
  • Proficiency in PC-based word processing and database documentation (Word, Excel, Internet, Outlook)
  • Reliable transportation daily to be able to travel within assigned territory
  • Ability to meet regulatory deadlines.
  • Has a dedicated home work space used only for business purposes and is able to comply with all telecommuter policies.
  • Experience in geriatric special needs, behavioral health, home health
  • Understanding of the importance of cultural competency in addressing targeted populations.
  • Experience with electronic documentation system(s)
  • Experience with cost neutrality and budgeting

Language (Other than English):
None
Travel Requirement:
25% - 50%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Works From Home
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Occasionally
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$72,700.00
Pay Range Maximum:
$116,600.00
Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice

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About Highmark Health

Sourced by ZipRecruiter

A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia, and eastern and northwestern New York with customers in 50 states and the District of Columbia. We passionately serve individual consumers and fellow businesses alike. And our companies cover a diversified spectrum of essential health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions. Our financial position reflects strength and stability, with our year-end 2022 consolidated revenues totaling $26 billion. And we're proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.

Industry

Health care and social assistance and insurance services

Company size

10,000+ Employees

Headquarters location

Pittsburgh, PA, US

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