What are the responsibilities and job description for the MEDICAL CASE MANGEMENT NURSE position at BRMS?
Description
Join the BRMS Medical Management Team!
Take your nursing career to the next level with Benefit & Risk Management Services (BRMS) — a trusted leader in self-funded healthcare administration. As a Medical Case Management Nurse, you’ll join a dynamic team that blends clinical excellence with innovation to improve member outcomes and manage healthcare costs effectively.
Working for a Third-Party Administrator (TPA) like BRMS offers a unique and fulfilling experience — you’ll use your nursing expertise to impact not just individual patients, but entire employer groups, helping members receive high-quality care while driving smarter healthcare decisions.
What You’ll Do
Manage cases for members with complex or chronic conditions to ensure appropriate, cost-effective treatment.
Coordinate communication between patients, providers, and insurance partners.
Review clinical information for quality, medical necessity, and benefit optimization.
Track, document, and analyze case activity to identify trends and cost-saving opportunities.
Develop individualized care plans and support members in navigating their healthcare journey.
Collaborate with Utilization Review, Claims, and other departments to ensure seamless medical management.
Participate in reporting, quality assurance, and process improvement initiatives.
Why Join BRMS
Be part of a collaborative, mission-driven team that values clinical insight and innovation.
Gain unique experience in the self-funded insurance world, where your work impacts both members and employers.
Work alongside experienced healthcare and benefits professionals who are dedicated to excellence.
Enjoy a stable weekday schedule in a supportive, professional environment.
Requirements
What You Bring
Graduate of an accredited school of nursing.
Active California RN Or LVN License (required).
Minimum 2 years of acute clinical experience and 1 year in case management or utilization review.
Knowledge of ICD-10, CPT, and HCPCS coding.
Strong communication, analytical, and organizational skills.
Experience with cost containment, quality assurance, or self-funded plans a plus.
Join the BRMS Medical Management Team!
Take your nursing career to the next level with Benefit & Risk Management Services (BRMS) — a trusted leader in self-funded healthcare administration. As a Medical Case Management Nurse, you’ll join a dynamic team that blends clinical excellence with innovation to improve member outcomes and manage healthcare costs effectively.
Working for a Third-Party Administrator (TPA) like BRMS offers a unique and fulfilling experience — you’ll use your nursing expertise to impact not just individual patients, but entire employer groups, helping members receive high-quality care while driving smarter healthcare decisions.
What You’ll Do
Manage cases for members with complex or chronic conditions to ensure appropriate, cost-effective treatment.
Coordinate communication between patients, providers, and insurance partners.
Review clinical information for quality, medical necessity, and benefit optimization.
Track, document, and analyze case activity to identify trends and cost-saving opportunities.
Develop individualized care plans and support members in navigating their healthcare journey.
Collaborate with Utilization Review, Claims, and other departments to ensure seamless medical management.
Participate in reporting, quality assurance, and process improvement initiatives.
Why Join BRMS
Be part of a collaborative, mission-driven team that values clinical insight and innovation.
Gain unique experience in the self-funded insurance world, where your work impacts both members and employers.
Work alongside experienced healthcare and benefits professionals who are dedicated to excellence.
Enjoy a stable weekday schedule in a supportive, professional environment.
Requirements
What You Bring
Graduate of an accredited school of nursing.
Active California RN Or LVN License (required).
Minimum 2 years of acute clinical experience and 1 year in case management or utilization review.
Knowledge of ICD-10, CPT, and HCPCS coding.
Strong communication, analytical, and organizational skills.
Experience with cost containment, quality assurance, or self-funded plans a plus.