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Rn Complex Case Manager Jobs (NOW HIRING)

MedStar Health

RN Case Manager

Washington, DC · On-site

Responsible for carrying a complex case management case load ownership of a case management program ... - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the ...

MedStar Health

RN Case Manager

Washington, DC · On-site

Responsible for carrying a complex case management case load ownership of a case management program ... - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the ...

Solvet

RN - Registered Nurse

Colchester, VT · Hybrid

Lead RN Non-Clinical Case Manager Colchester, VT Monday-Friday Schedule Vermont Army National Guard ... Experience coordinating complex medical or case management activities * Ability to manage sensitive ...

RN

Registered Nurse, Case Manager

Auburn, NY · On-site

$75K - $87K/yr

... seeking RN Case Managers to join our teams in Onondaga, Oneida, Oswego, Jefferson, or Cayuga ... complex medical needs in the comfort of their homes, helping patients maintain independence ...

RN

Registered Nurse, Case Manager

Auburn, NY

$75K - $87K/yr

... seeking RN Case Managers to join our teams in Onondaga, Oneida, Oswego, Jefferson, or Cayuga ... complex medical needs in the comfort of their homes, helping patients maintain independence ...

RN

Registered Nurse, Case Manager

Oswego, NY

$75K - $87K/yr

... seeking RN Case Managers to join our teams in Onondaga, Oneida, Oswego, Jefferson, or Cayuga ... complex medical needs in the comfort of their homes, helping patients maintain independence ...

RN

Registered Nurse, Case Manager

Rome, NY

$75K - $87K/yr

... seeking RN Case Managers to join our teams in Onondaga, Oneida, Oswego, Jefferson, or Cayuga ... complex medical needs in the comfort of their homes, helping patients maintain independence ...

RN

Registered Nurse, Case Manager

Syracuse, NY

$75K - $87K/yr

... seeking RN Case Managers to join our teams in Onondaga, Oneida, Oswego, Jefferson, or Cayuga ... complex medical needs in the comfort of their homes, helping patients maintain independence ...

Registry Ally, Inc.

RN - COMPLEX CARE

Los Angeles, CA · On-site

Join a purpose-driven team in downtown Los Angeles as a Complex Care Registered Nurse (RN) ... This is not a case management role Requirements * Active, unrestricted California Registered Nurse ...

Registry Ally, Inc.

RN - COMPLEX CARE

Los Angeles, CA

Complex Care Registered Nurse (RN) Join a purpose-driven team in downtown Los Angeles as a Complex ... This is not a case management role Requirements: Active, unrestricted California Registered Nurse ...

Presbyterian Healthcare Services

$34.68 - $52.95/hr

... complex case discussions to optimize length of stay and patient outcomes. * Drive Quality ... Qualifications: RN IMM Case Management I * Associates Degree in nursing required. * *BSN within 5 ...

Registry Ally, Inc.

RN - COMPLEX CARE

Los Angeles, CA · On-site

Complex Care Registered Nurse (RN) Join a purpose-driven team in downtown Los Angeles as a Complex ... This is not a case management role Requirements: Active, unrestricted California Registered Nurse ...

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How much do rn complex case manager jobs pay per hour?

As of Jun 5, 2026, the average hourly pay for rn complex case manager in the United States is $47.53, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $57.45 per hour, depending on experience, location, and employer.

What is the difference between Rn Complex Case Manager vs Rn Care Coordinator?

AspectRn Complex Case ManagerRn Care Coordinator
CertificationsRN license, case management certification often preferredRN license, case management certification often preferred
Work EnvironmentHealthcare facilities, insurance companies, community healthHospitals, clinics, outpatient settings
Primary FocusManaging complex patient cases, coordinating care plansCoordinating patient care, scheduling, patient education

The main difference is that Rn Complex Case Managers focus on managing complex cases with multiple health issues, requiring advanced care planning and coordination. Rn Care Coordinators primarily handle patient scheduling and basic care coordination. Both roles require RN licensure and often similar certifications, but their responsibilities and work environments differ slightly.

What is an RN Complex Case Manager?

An RN Complex Case Manager is a registered nurse who specializes in coordinating care for patients with complex medical needs. They assess, plan, and facilitate care by working with interdisciplinary teams, patients, and families to ensure optimal health outcomes. Their role often involves managing chronic conditions, coordinating resources, and advocating for patients throughout the healthcare continuum. They help reduce hospital readmissions and improve quality of life by providing personalized support and education.

How does an RN Complex Case Manager typically collaborate with interdisciplinary teams to support patient outcomes?

As an RN Complex Case Manager, you work closely with a variety of professionals, including physicians, social workers, pharmacists, and therapists, to develop and coordinate comprehensive care plans for patients with complex medical needs. Regular interdisciplinary meetings are common, where you discuss patient progress, identify barriers to care, and adjust plans as needed. Effective communication and documentation are essential, as you often serve as the main point of contact between the patient, their family, and the healthcare team. This collaborative approach helps ensure that all aspects of the patient's care are addressed and optimized for the best possible outcomes.

What are the key skills and qualifications needed to thrive as an RN Complex Case Manager, and why are they important?

To thrive as an RN Complex Case Manager, you need a valid RN license, strong clinical assessment skills, and experience in case management or care coordination. Familiarity with case management software, electronic health records (EHRs), and relevant certifications like CCM (Certified Case Manager) are often required. Excellent communication, problem-solving abilities, and empathy are crucial for building relationships with patients and collaborating with multidisciplinary teams. These skills ensure effective care planning, improved patient outcomes, and efficient resource utilization for individuals with complex health needs.
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Rn Complex Case Manager jobs near you
RN Case Manager

RN Case Manager

MedStar Health

Washington, DC • On-site

Full-time

Posted 14 days ago

Medstar Health rating

7.8

Company rating: 7.8 out of 10

Based on 238 frontline employees who took The Breakroom Quiz

131st of 865 rated healthcare providers

Job description

About the Job
General Summary of Position
Coordinates negotiates procures and manages care of our members/enrollees to facilitate cost effective care and members/enrollees satisfaction. Facilitates the continuum of care works collaboratively with interdisciplinary staff internal and external to the organization. Responsible for carrying a complex case management case load ownership of a case management program(s) pre- authorization reviews to provide Medically Necessary timely and quality health care services in the most cost-effective manner and pharmacy reviews per population served. This role would include the ability to meet memebers in their homes or various community settings. We recruit retain and advance associates with diverse backgrounds skills and talents equitably at all levels.
Primary Duties and Responsibilities
  • Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
  • Actively develops and manages complex case management cases and develops individualized plans of care according to NCQA standards/ guidelines and the District of Columbia Contract.
  • Acts as a liaison to MedStar Family Choice contracted vendors to facilitate care. Identifies gaps in contracted services and develops a plan to access care.
  • Acts as an advocate while assisting members/enrollees to coordinate and gain access to medical psychiatric psychosocial and other essential services to meet their healthcare needs. Authorizes and monitors covered services according to policy.
  • Assists hospital case management staff with discharge planning if applicable. Makes recommendation to alternate tier of Case Management programs or level of care as acuity necessitate.
  • Attends and participates in MFC staff meetings Clinical Operations department meetings Special Needs Forums work groups District/ community agencies meetings etc. as assigned. Provides input completes assignments and shares new findings with other staff. Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
  • Provides face to face case management in the community as the member/enrollee's health necessitate.
  • Demonstrates behavior consistent with MedStar Health mission vision goals objectives and patient care philosophy.
  • Demonstrates skill and flexibility in providing coverage for other staff.
  • For assigned Case Management program(s) develops strategies assessment(s) and evaluation/goal tools according to NCQA standards/ guidelines and District of Columbia Contract for the population served. Utilizes standards/ guidelines to manage and document interactions for the program (s). Responsible for verifying that assigned program utilizes up-to-date standards in the medical and behavioral health community for the population served. Keeps informed about disease processes treatment modalities and resources.
  • Identifies and reports potential coordination of benefits subrogation third party liability worker's compensation cases etc. Identifies quality risk or utilization issues to appropriate MedStar personnel.
  • Identifies inpatients requiring additional services and initiates care with appropriate practitioners.
  • Maintains current knowledge of MFC benefits and enrollment issues in order to accurately coordinate services.
  • Maintains timely and accurate documentation in the clinical software system per Clinical Operation department's policy.
  • Monitors utilization of all services for fraud waste and abuse.
  • Performs telephonic ACD line coverage for Clinical Operations' needs.
  • Enters authorization as appropriate to the program and sends the reviews to Medical Director as appropriate. Coordinates review decisions and notifications per policy NCQA standards/ guidelines and District of Columbia Contract for timely decision making.
  • Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
  • Participates in multi-disciplinary quality and service improvement teams.

Minimal Qualifications
Education
  • Graduate of an accredited School of Nursing required and
  • Bachelor's degree preferred

Experience
  • 1-2 years Case management experience required and
  • 1-2 years UM or related experience required and
  • 3-4 years Diverse clinical experience required

Licenses and Certifications
  • RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the District of Columbia and/or the State of Maryland based on work location(s) Upon Hire required and
  • CCM - Certified Case Manager Upon Hire preferred

Knowledge Skills and Abilities
  • Verbal and written communication skills. Ability to use computer to enter and retrieve data. Ability to create edit and analyze Microsoft office (Word Excel and PowerPoint) preferred.

This position has a hiring range of
USD $89,065.00 - USD $162,801.00 /Yr.

What Medstar Health employees say

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About Medstar Health

Sourced by ZipRecruiter

MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Columbia, MD, US

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