RN Case Manager

Job Title: RN Case Manager

Location: NW Washington, DC 20007
Employment Type: Contract to Hire
Schedule: 40 hours/week | 4 days onsite, 1 day remote (typically Friday)
Pay Rate: $46.00-$49.00/hour
Openings: 4 (due to growth)

Interview Process:

• One 30-minute virtual interview with Nannette and Fonya
• 24-48 hour feedback turnaround

Education Requirement: Bachelor's Degree
Licensure: Active DC RN License required at time of hire

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Position Overview

The RN Case Manager is responsible for managing a complex patient population with chronic conditions such as diabetes, hypertension, and COPD. This role focuses on care coordination, discharge follow-up, telephonic assessments, and detailed clinical documentation. The position requires strong clinical judgment, attention to detail, and adherence to NCQA standards.

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Key Responsibilities

• Manage a caseload of up to 45 patients with complex and chronic conditions.
• Conduct telephonic clinical assessments and maintain regular contact with enrollees (at least every two weeks).
• Develop, implement, and manage individualized care plans in accordance with NCQA guidelines and DC contract requirements.
• Coordinate care across medical, behavioral health, and community services to ensure comprehensive patient support.
• Act as a liaison between patients, providers, and contracted vendors to facilitate timely and appropriate care.
• Identify gaps in care and implement strategies to improve access and outcomes.
• Support hospital discharge planning and recommend appropriate levels of care based on patient needs.
• Maintain accurate, timely, and audit-ready documentation in clinical systems.
• Monitor services for quality, utilization, and potential fraud, waste, or abuse.
• Participate in interdisciplinary meetings, quality improvement initiatives, and community outreach efforts.
• Enter authorizations and coordinate review decisions in compliance with NCQA standards and regulatory requirements.
• Provide occasional in-person case management support in the community as needed.

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Day-to-Day Responsibilities

• Follow up on hospital discharges
• Perform telephonic outreach and assessments
• Complete detailed clinical documentation
• Collaborate with interdisciplinary teams
• Manage high-acuity patient cases with frequent hospitalizations

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Required Qualifications

• Active DC RN License (required upon hire)
• Minimum 2 years of general nursing experience
• 1-2 years of case management experience
• Experience working with high-acuity patients and frequent hospital utilizers
• Familiarity with NCQA standards and guidelines

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Preferred Qualifications

• Certified Case Manager (CCM)
• Experience in managed care or health plan environments

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Additional Information

• Work involves a mix of telephonic and occasional face-to-face patient interactions
• Heavy emphasis on documentation quality and audit readiness
• Opportunity to work within a collaborative, mission-driven care team

If you have any questions about the information provided above, please feel free to apply to this posting and I will follow up with you shortly after to discuss the role and provide you with a more detailed job description.

Thank you,
Ryan Jacobs

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?