Role Description 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 Iowa, Arizona, or Idaho. Schedule: This position works four 10-hour shifts per week and must be able to support ICM’s standard operating hours of 8:00 AM–5:00 PM Pacific Time. Specific shift times may vary based on business needs and the candidate’s time zone. 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 Qualifications - Active, unrestricted Registered Nurse (RN) license in good standing - Associate’s or Bachelor’s degree in Nursing - 5+ years of clinical nursing experience - Oncology nursing experience - Experience in case management - 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 - Case management or utilization certifications (e.g., CCM, CPUR, CPHM) - Oncology Certified Nurse certification, or OCN - Experience using NCCN Clinical Practice Guidelines in Oncology to support oncology case management, care coordination, or utilization review - 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 - Multi-state licensure

• In-depth understanding (“expert user”) of the functionality and capability of Customer Service tools • Facilitate with clients and ensure their needs are met and compile client reports as requested • Routes or answers all incoming communication (email, phone, or other) from customers and clients • Keeps up to date on course/curriculum offerings’ changes to certification tracks; recommend course orders • Become familiar with all Skillsoft products, including Percipio, Books24x7 and Skillsoft Compliance and Skillsoft Coaching • Be attentive to service level agreements

Role Description The Infusion Scheduler is responsible for coordinating and scheduling initial infusion appointments, follow-up infusion visits, and maintaining efficient daily infusion schedules within a fast-paced rheumatology practice. This role plays a critical part in optimizing infusion chair utilization, supporting patient access to care, and ensuring efficient infusion suite operations. The ideal candidate is highly organized, proactive, detail oriented, and able to manage scheduling workflows while providing exceptional customer service to patients and clinical staff. This is a fully remote position; however, employees must reside within the state of Florida. Key Responsibilities - Infusion Scheduling & Coordination - Schedule initial infusion appointments and recurring follow-up infusion visits. - Coordinate infusion schedules based on medication protocols, infusion duration, provider orders, and chair availability. - Maintain accurate infusion schedules for all applicable suite locations. - Work with infusion nurses, infusion/biologic coordinators, providers, and office staff regarding scheduling needs and patient flow. - Work closely with providers, medical assistants, and onsite managers regarding scheduling needs and patient flow. - Maintain scheduling accuracy and ensure appropriate appointment durations are utilized. - Schedule Optimization - Monitor infusion schedules throughout the day and proactively address scheduling gaps, cancellations, and changes. - Contact patients regarding earlier appointment availability or schedule openings. - Assist in optimizing infusion chair utilization and maintaining efficient patient flow. - Maintain waitlists and assist with rescheduling appointments as needed. - Communicate schedule updates and changes promptly to patients and staff. - Patient Service - Provide exceptional customer service to patients, providers, and staff. - Answer incoming scheduling calls professionally and efficiently. - Accurately document scheduling communications and appointment notes within the electronic medical record (EMR) system. - Educate patients regarding infusion appointment scheduling, arrival times, and general appointment instructions. - Maintain strict patient confidentiality and professionalism. - Administrative - Verify patient demographics and insurance information during scheduling. - Maintain accurate provider calendars and scheduling templates. - Follow organizational scheduling workflows, policies, and productivity expectations. - Assist with additional administrative and operational duties as assigned. - Follow all OSHA, HIPAA, and SAC privacy and safety standards. - Other duties as assigned. Qualifications - High school diploma or equivalent required. - Minimum of 2 years of medical scheduling or healthcare administrative experience preferred. - Strong communication and customer service skills. - Ability to multitask in a fast-paced environment. - 1+ year experience in rheumatology, internal medicine, or other specialty practice, preferred. - Experience with EMR systems; familiarity with NextGen is a plus. - Strong organizational skills. - Strong attention to detail and problem-solving abilities. - Ability to prioritize tasks and adapt to changing schedules. Equal Employment Opportunity Sarasota Arthritis Centers provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

• Manage a large volume of incoming calls and email communication • Respond to customer queries accurately and in a timely manner through email or phone • Answer calls from referral sources in a timely and professional manner, and answer questions regarding the referral process to satisfy our customers • Facilitate with Follow-Up communication for Spanish-speaking patients by contacting the patient, provider, or on-line tracking system to confirm items were delivered and/or services rendered • Communicate with supervisor, peers, and external parties to keep them informed of updates regarding patients or payers, including outlying situations that could affect the referral • Collect and enter accurate and detailed patient, provider, and payer information into the Company’s claims platform on a real-time basis to prevent delays in coordinating services or billing • Work with patients/clients/beneficiaries’ insurance companies to assist in resolving issues or concerns • Answer questions from patients, staff, insurance companies, providers, and payer sources • Ensure patients receive a high standard of service delivery and care through a series of quality questions to ensure Company quality standards are being met • Being on the phone is a required and essential function of the job • Identify and resolves service issues and complaints • Intake new orders as needed • Maintain knowledge of company policies and procedures and regulatory, contractual, and accreditation requirements • Remain available for after hours on-call coverage • Follow strict confidentiality and HIPAA privacy and security guidelines • Perform other duties as assigned