About The Role The Case Manager Nurse plays a critical role in supporting members with complex or chronic conditions by providing proactive, telephonic case management grounded in a whole-person approach. This role focuses on reducing avoidable utilization, improving care coordination, and helping members navigate the healthcare system with confidence and clarity. As a trusted clinical resource, the Case Manager Nurse partners closely with members, providers, and health plans to assess needs, develop individualized care plans, and advocate for appropriate, cost-effective services. In addition to core case management responsibilities, this role also supports utilization review activities when needed, contributing to timely medical necessity determinations and continuity of care. This position is ideal for an experienced RN who brings strong clinical judgment, excellent communication skills, and a passion for improving outcomes for high-need populations in a collaborative, remote care management environment. This is a fully remote role. Candidates must reside in Oregon, Washington, Nevada, or Arizona. Schedule: Monday–Friday | 8:00 AM–5:00 PM Pacific Time What You'll Do Patient Identification & Assessment - Identify members who would benefit from case management using claims data, referrals, and clinical records - Review referrals for clinical appropriateness using sound judgment and program parameters - Conduct comprehensive assessments of medical, behavioral, and social needs using a whole-person approach Care Planning & Coordination - Develop individualized care plans based on patient needs, barriers, and goals - Coordinate care across the continuum, including primary care, specialists, behavioral health, and community-based resources - Facilitate clear communication between patients, providers, caregivers, and health plans to support safe transitions of care and adherence to treatment plans Clinical Case Management & Advocacy - Provide telephonic case management for high-utilization patients with complex or chronic conditions - Use best practices in chronic disease management, motivational interviewing, and patient education - Advocate for timely, appropriate, and cost-effective care while balancing clinical judgment with plan guidelines - Support patients in navigating healthcare systems and overcoming barriers to care Utilization Review & Medical Decision-Making Evaluate precertification requests using evidence-based criteria and plan-specific guidelines - Review ongoing inpatient stays and make length-of-stay determinations as appropriate - Partner with Appeals & Denials and/or in-house providers to support complex clinical decisions Documentation, Reporting & Compliance - Document all assessments, interventions, communications, and determinations thoroughly and accurately in ICM systems - Provide client-facing reports summarizing interventions, outcomes, and estimated cost savings - Ensure compliance with internal policies, regulatory requirements, and HIPAA standards Collaboration, Leadership & Continuous Improvement - Partner with other clinical teams across ICM to remove care barriers and improve patient outcomes - Serve as a senior clinical resource, contributing to program development, cross-training, and process improvement - Stay current on best practices, regulations, and clinical guidelines related to case management - Participate in training, quality assurance initiatives, and professional development What You Bring Required - Active, unrestricted Registered Nurse (RN) license in good standing - Associate’s or Bachelor’s degree in Nursing - 5+ years of clinical nursing experience - Strong knowledge of chronic disease management, utilization management, and social determinants of health - Experience managing complex, high-utilization patient populations - Excellent written and verbal communication skills with empathy, professionalism, and emotional intelligence - Strong organizational skills with the ability to manage multiple priorities independently - Sound clinical judgment and confidence navigating complex or sensitive situations - Comfort working independently in a remote environment with strong accountability and follow-through - Ability to manage confidential information in compliance with HIPAA Even Better If You Have - Experience in case management, care coordination, or discharge planning - Experience in a TPA or self-funded health plan environment - Knowledge of health insurance regulations and utilization management processes - Experience using medical necessity criteria and utilization review tools - Experience with EMRs and care management platforms - Mental health and/or substance use disorder (MH/SUD) case management experience - Multi-state licensure - Case management or utilization certifications (e.g., CCM, CPUR, CPHM)

table.MiTabla { max-width: 1020px;!important Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global healthcare company that since 1909 has been working to improve the health and well-being of people around the world. We are leaders in plasma-derived medicines and transfusion medicine and develop, produce and market innovative medicines, solutions and services in more than 110 countries and regions. APPLICATION DEADLINE 01/30/26 The Medical Science Liaison develops and maintains professional relationships with current and future thought leaders whose research, teaching, and publications are authoritative and whose opinions are considered important in the Immunology and Neurology therapeutic area (MSL primary call points include Immunology, Neurology, Hematology/Oncology).   This position is a remote full time role located in the Central/Midwest regions of the US - CO, MO, KS, NM, NE, IA, MN, WI, IL, IN, OH, or MI. Estimated travel is 60%.     Primary responsibilities include but are not limited to: - Identifies, develops, and maintains collaborative relationships with key opinion leaders through knowledge exchange on cutting-edge scientific trends, ideas, and practices in patient care as well as understanding the dynamics and unmet needs within the therapeutic areas - Serves as an information scientist and colleague to top level academic physicians and researchers, select academic centers, centers of excellence, patient advocacy groups, and key accounts, including managed care, by providing complex medical and scientific information to meet their needs - Serves as a conduit for research for investigators interested in developing investigator-initiated research protocols - Strengthens alliances with cross-functional colleagues by support at medical conventions, advisory boards, clinical data presentations, scientific intelligence, promotional speaker training, company trial site - Conducts formal presentations upon request to appropriate groups such as: key accounts, managed care organizations, integrated systems, national medical associations and medical schools. Acts as an “ambassador” representing Grifols’ position and interests regarding research, current and future drug development and corporate mission - Adheres to company policies and complies with applicable regulatory and legal requirements with highest ethical standards   Skills/Qualifications/Education: (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, education, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions)   - MSL must live in region, ideally near a major airport in CO, MO, KS, NM, NE, IA, MN, WI, IL, IN, OH, or MI - Strong science/clinical background with advanced degree in a scientific field of study (PharmD, MD, PhD or advanced/Master’s nursing degree) - Experience typically requires minimum of 2 years of related experience in clinical practice, academics, or pharmaceutical industry - Comprehensive knowledge of Grifols philosophy and policies - Excellent interpersonal, strategic, and communication skills - Excellent ability to understand, interpret, and communicate complex scientific and medical information and data - Ability to comfortably converse with key academic opinion leaders regarding highly technical information - Excellent ability to demonstrate computer literacy and learn programs and procedures used in the day-to-day functions of an MSL - Ability to be a self-starter, handle multiple projects simultaneously - Ability to manage a demanding travel schedule and be flexible - Depending on the area of assignment, directly related experience or a combination of directly related education and experience and/or competencies may be considered in place of the stated requirements. Example: If a job level requires a Bachelor’s degree plus 4 years of experience, an equivalency could include 8 years of experience, an Associate’s degree with 6 years of experience, or a Master’s degree with 2 years of experience. Work is performed in an office environment with exposure to electrical office equipment. Frequently sits for 6-8 hours per day. Frequent hand movement of both hands with the ability to make fast, simple movements of the fingers, hands, and wrists. Occasionally walks. Occasionally bends and twists neck. Light to moderate lifting and carrying objects with a maximum lift of 25lbs. Frequently drives to site locations with occasional travel within the United States. Able to communicate complex information and ideas so others will understand; with the ability to listen to and understand information and ideas presented through spoken words and sentences. Works independently with little guidance or reliance on oral or written instructions and plans work schedules to meet goals. Frequently interacts with others, relates sensitive information to diverse groups. Must work with diverse groups to obtain consensus on issues. Ability to apply abstract principles to solve complex conceptual issues. Pay scale from $150,000 - $175,000 per year, depending on license and experience. The pay scale for the Sr. MSL is from $185,000 - $215,000 per year, depending on license and experience.This position is eligible to participate in up to 15% of the company bonus pool. We offer benefits including medical, PTO, up to 5% 401K match, and tuition reimbursement. We are committed to offering our employees opportunities for professional growth and career progression. Even though we are a global healthcare company with employees in 30 countries, Grifols prides itself on its family-like culture. Our company has more than tripled its workforce in the last 10 years — we’re growing, and you can grow with us! #LI-YR1 #LI-REMOTE Third Party Agency and Recruiter Notice: Agencies that present a candidate to Grifols must have an active, nonexpired, Grifols Agency Master Services Agreement with the Grifols Talent Acquisition Department. Additionally, agencies may only submit candidates to positions that they have been engaged to work on by a Grifols Recruiter. All resumes must be sent to a Grifols Recruiter under these terms or they will be considered a Grifols candidate. Grifols provides equal employment opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability or any other characteristic or status protected by law. We will consider for employment all qualified Applicants in a manner consistent with the requirements of applicable state and local laws. Location: NORTH AMERICA : USA : CO-Denver || NORTH AMERICA : USA : IA-Des Moines || NORTH AMERICA : USA : IL-Chicago || NORTH AMERICA : USA : IN-Indianapolis || NORTH AMERICA : USA : MI-Detroit || NORTH AMERICA : USA : MN-Minneapolis || NORTH AMERICA : USA : MO-Kansas City || NORTH AMERICA : USA : NE-Omaha || NORTH AMERICA : USA : NM-Albuquerque || NORTH AMERICA : USA : OH-Cleveland || NORTH AMERICA : USA : OH-Columbus || NORTH AMERICA : USA : WI-Milwaukee:[[cust_building]] Learn more about Grifols

Type of Requisition: Pipeline Clearance Level Must Currently Possess: None Clearance Level Must Be Able to Obtain: None Public Trust/Other Required: None Job Family: Science and Research Job Qualifications: Skills: Grant Research, Life Science, Research Grants, Scientific Reviews, Waterfall ModelCertifications: NoneExperience: 5 + years of related experienceUS Citizenship Required: No Job Description: Scientific Review Officer (Part Time On Call) GDIT assists federal, state and private grant-funding agencies helping them identify the most promising research projects to fund by conducting a fair and thorough assessment of scientific merit by a panel of expert reviewers. GDIT has the capability of working with a diverse portfolio of research programs including multiple cancer research areas (e.g. breast, prostate, lung, kidney), neurosciences (e.g. autism, Alzheimer’s, Parkinson’s, epilepsy) and areas of interest in military health (e.g. traumatic brain injury, spinal cord injury, psychological health, orthopedics) plus educational research. Rigorous and fair peer review is the foundation of sound grant funding decisions. We are currently seeking Scientific Review Officers (SROs) to join our team. As an SRO you will work remotely on an intermittent basis, helping identify qualified reviewers who have relevant subject matter expertise. Also, SROs help manage the peer review process, so the reviewers consistently apply the program's review criteria to all applications. The SRO position is a part time on call position on a long-term basis with variable time requirements along the review cycle. To remain in good standing on the team SROs will typically work a minimum of 3-4 Peer Review projects per year. High performers may work on up to 9-10 Peer Review projects. Billable hours for each Peer Review project will vary depending on the size and complexity of the assignment. While SRO positions are home-based with flexible hours, they also require flexibility in the candidates’ schedule to be available for up to 8 hours on certain days and may require travel to peer review meetings as needed (each meeting may require up to a 4-day travel commitment). Candidates should not have a current research grant or be applying for research grants, or work for federally funded programs. Since it is a part time position, it is possible to combine this work with other jobs if they don’t pose a conflict for GDIT and/or our clients. Responsibilities • Recruits qualified reviewers regarding the subject matter expertise required by the panel and to meet the overall criteria outlined by the client • Provides appropriate guidance and instruction to reviewers regarding relevant review policies, guidelines, and criteria, and monitors critique preparation and submission by reviewers. Monitors conflicts of interest issues • Administrates and facilitates peer review meetings following established policies • Prepares the documentation outlining the outcomes of the peer review process Required Qualifications • Possess an MD, DVM and/or PhD degree • Have 5+ years of work experience after postdoctoral work • Demonstrate outstanding verbal and writing skills, meticulous attention to detail, excellent organizational and time management skills, and the ability to meet deadlines • Show ability to troubleshoot problems and find quick solutions while adhering to established policies • Have the flexibility in your overall work schedule to address urgent issues immediately without delays • Proficiency in MS Outlook, MS Excel, MS Teams and Zoom Additional Desired Qualifications • Have 10+ years of work experience after postdoctoral work • Be a veteran or civilian with prior (not current) experience in a Military Treatment Facility (MTF) or DoW Laboratory • Possess clinical work experience # GDITHealth The likely hourly rate for this position is between $51.00 - $69.00. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range. Scheduled Weekly Hours: 8 Travel Required: Less than 10% Telecommuting Options: Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most. We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology. Join our Talent Community to stay up to date on our career opportunities and events atgdit.com/tc. Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans

Department: Status: Part time Benefits Eligible: Yes Hours Per Week: 32 Schedule Details/Additional Information: Pay Range $35.50 - $53.25 Schedule: Part-time, either 3 (10 hour) shifts or 4 (8 hour) shifts. Day/pm hours available. Every fourth weekend and holiday rotation. **Candidate MUST have 2+ years' acute care experience (ED, Urgent Care, ICU and some Med/Surg will be considered) is required within the last 4 years to be considered.** Due to complex requirements, remote work is NOT permitted from the following states: CA, CO, CT, HI, MA, MD, MN, NJ, NY, OR, RI, VT, WA Schedule: - Part time position (30 or 32 hours) - start times mornings 8a,9a or 10a, PMs 12p, 1p, 2p or later - 8 hour or 10 hour shifts are available for different shifts - MUST be available to work every 4th weekend and holiday rotation Major Responsibilities: - Uses the nursing process and guidance of established protocols to assess the needs of the patient telephonically including the patient, guardian, or family in the conversation when necessary. Determines most appropriate level of care needed, provides detailed education, establishes a plan of care including interventions, and communicates follow up instructions to the patient. Escalates and collaborates with the appropriate on call provider when additional guidance is needed. - Prioritizes patient interactions by acuity and need considering all available information and resources. Applies evidence-based practice to deliver patient care. - Implements strategies to reduce patient risk and increase patient safety. Assesses patient and family readiness to learn and individualizes the approach as necessary. Works collaboratively to develop strategies to meet the learning needs of the patient and family. - Supports shared governance activities and initiatives to improve processes and patient outcomes. - Participates in department quality/process improvement initiatives aimed at enhancing the patient care experience. - Participates in professional activities which contribute to personal professional development and the development of others. Seeks opportunities to be taught, coached, and mentored. Attends required meetings/educational programs and completes annual competencies in a timely manner. - Demonstrates effective communication, feedback, and conflict resolution skills. Promotes collaboration with clinicians and other healthcare team members to coordinate patient-centered care. - Promotes a culture of safety through identifying threats to patient safety and intervening to prevent patient harm. Reports patient safety events and near misses in a timely manner. Seeks to identify potential safety issues and assists in the implementation of corrective action. - Applies ethical decision making, demonstrates respect and understanding for peers, and other clinical disciplines. Participates as an effective member of the patient care team to formulate an integrated, unbiased, individualized approach to care. - Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret appropriate information needed to identify each patient’s requirements relative to his/her age specific needs and provide the care advice/disposition outlined in the departments policies, procedures, and protocols. Schedules appointments with emphasis on making the appointment in correlation to the recommended end point of the protocol used. Collaborates with other health care team members to coordinate medical and nursing management of patient care, including procedures and medication refills. - Accurately maintains and updates the patient’s clinical records according to agency, State and Federal guidelines. Documents all call encounters utilizing the patient’s Electronic Medical Record at the time of the call. Communicates information relating to the patient’s physical and psychological status to the physician, Advanced Practice Clinician and/or additional members of the interdisciplinary team as appropriate. Provides pertinent and concise reports describing patient’s response to medical and nursing plans of care. - Participates in team meetings and works on special projects/tasks as assigned by leadership. Participates in the ongoing development of comprehensive health information resources, system and operational efficiencies and resources. Assists in interpreting department policies and procedures and advises staff on procedural changes. Licensure, Registration, and/or Certification Required: - Registered Nurse license issued by the state in which the team member practices. Education Required: - Associate's Degree (or equivalent knowledge) in Nursing. Experience Required: - Typically requires 2+ years' of acute care experience, preferably within the last 4 years (ED, Urgent Care, ICU and some Med Surg will be considered). Knowledge, Skills & Abilities Required: - Critical thinking skills necessary to independently determine and prioritize the needs of patients using sound judgment and strong problem-solving skills. - Knowledge of a variety of healthcare specialties, including levels of care, symptom identification and proven treatment recommendations. Ability to incorporate past experience with established protocols. - Excellent verbal communication skills demonstrating empathy, respect, restatement, open-ended questions, active listening and diplomacy with a diverse customer population. - Ability to develop rapport and maintain positive, professional relationships with a variety of patients, staff and physicians. - Proven ability to independently organize and prioritize work, managing multiple priorities and maintaining a flexible schedule in a fast paced, dynamic customer service environment. - Excellent customer service and follow-up skills including the ability to stay calm during stressful situations. - Demonstrated proficiency as a technology user with computers, internet, desktop software packages and multiple-line telephone systems. - Ability to converse with customers/patients while researching and documenting calls on multiple systems. Knowledge of documentation techniques for communication Physical Requirements and Working Conditions: - Required stable and secure internet connection - Must have functional vision, touch, speech, and hearing. - Required sitting a majority of the workday. - Operates all equipment necessary to perform the job. - Must have quiet space to make and receive phone calls - Ability to lift 15 lbs. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation - Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training - Premium pay such as shift, on call, and more based on a teammate's job - Incentive pay for select positions - Opportunity for annual increases based on performance Benefits and more - Paid Time Off programs - Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability - Flexible Spending Accounts for eligible health care and dependent care expenses - Family benefits such as adoption assistance and paid parental leave - Defined contribution retirement plans with employer match and other financial wellness programs - Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.