Case Manager RN

Actalent is Hiring a Team of RN Case Managers // Must Have Pediatric Case Manager Experience!!

Job Description

Join a mission-driven team dedicated to improving maternal and child health outcomes across Florida. As an RN Case Manager, you will play a pivotal role in managing chronic and complex medical needs for members across the continuum of care. This role offers flexibility, training opportunities, and the chance to make a measurable impact on community health. You will support the practitioner-patient relationship by acting as a liaison, promoting adherence to preventive care, and helping members self-manage their chronic conditions.

Responsibilities

• Coordinate comprehensive care and conduct clinical assessments.
• Develop individualized SMART care plans for members.
• Provide education to members and facilitate multidisciplinary team collaboration.
• Ensure compliance with Medicaid contracts, organizational policies, and PCMH standards.
• Drive improved health outcomes and reduce gaps in care.
• Perform risk stratification and support hospital discharge planning.
• Conduct outreach to high-risk or high-utilization members.
• Track clinical outcomes and identify barriers to treatment adherence.
• Document in accordance with quality, regulatory, and accreditation standards.
• Participate in team huddles and escalate questionable treatment plans to medical leadership.

Essential Skills

• Active RN licensure in Florida.
• 3–5 years of clinical experience in chronic disease management or complex case management.
• Experience working in PICU or other complex pediatric care settings.
• Familiarity with Medicaid/Medicare regulatory requirements.
• Strong ability to develop and execute SMART care plans.
• High-level communication skills for member education and team coordination.
• Experience with discharge planning, care plan creation, and resource referral.

Additional Skills & Qualifications

• Certified Case Manager (CCM) credential preferred.
• Experience with EPIC or similar EHR systems.
• Motivational interviewing experience.
• Experience with utilization management processes such as authorizations and appeals.

Work Environment

This hybrid role is based in Florida, with 80-100% remote work.

This is a Contract to Hire position based out of Miami, FL.

The pay range for this position is $38.00 - $42.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

This is a hybrid position in Miami,FL.

This position is anticipated to close on Mar 13, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $38 - $42