RN Case Manager

Company: RNR Business Solutions
Schedule: Monday–Friday, 9:00 AM – 6:00 PM CST (U.S. Time)
Location: Remote
Employment Type: Full-Time, Contract

About the Role

RNR Business Solutions, a boutique business process outsourcing and operations consulting firm, is hiring a Registered Nurse (RN) to serve as a Virtual Case Manager for a U.S.-based wound care client. We prefer that the RN have a US compact state license (ie. Texas, CO, etc.)

This position is ideal for a strong leader and critical thinker with excellent communication skills and a passion for patient care coordination. You’ll play a vital role in managing clinical operations, ensuring compliance, and supporting providers remotely.

Key Responsibilities

Clinical Case Management & Coordination
• Coordinate patient care with providers, home health agencies, and hospice partners.
• Manage and follow up on provider orders, referrals, and patient requests.
• Lead weekly provider meetings to review clinical updates and pending cases.
• Ensure smooth coordination of care for patients requiring wound management and follow-up.

Compliance & Documentation
• Audit provider notes and medical records for clinical completeness and accuracy.
• Review and submit ADR (Additional Documentation Request) packets to insurance.
• Ensure compliance with Medicare LCD guidelines, clinical standards, and HIPAA.
• Verify that documentation supports accurate billing and claim submissions.

Billing & Quality Review
• Review and approve provider invoices for completeness prior to payout.
• Identify documentation gaps or inconsistencies and work with providers to resolve them.
• Assist with billing-related audits and internal compliance checks.

Professional Development & Collaboration
• Participate in weekly case management and provider meetings.
• Be open to learning about advanced wound care, including skin grafts and cellular tissue products.
• Contribute to workflow improvements and clinical process development.

And other duties as assigned.

Qualifications
• Active U.S. RN license (Compact State required).
• Minimum of 3+ years of nursing experience (case management or wound care preferred).
• Experience reviewing medical records and understanding clinical documentation requirements.
• Strong leadership and critical thinking skills.
• Excellent written and verbal English communication.
• Strong understanding of Medicare, LCDs, and HIPAA compliance.
• Proficient with EMR/EHR systems and online communication tools.
• Reliable internet connection and quiet workspace, VPN, dual monitors, back up for lost connections


Why Join RNR Business Solutions

RNR is a boutique BPO and consulting firm that partners with U.S. healthcare organizations and service businesses to deliver operational excellence through smart systems and high-performing teams. We value accountability, precision, and growth. When you join us, you’re not just filling a role — you’re helping shape the standard of remote clinical excellence.


To Apply:
Please include:
1. A copy of your active U.S. RN license (Compact State).
2. Your updated resume detailing your nursing and case management experience.
3. A brief paragraph on why you’re a great fit for a wound care and compliance-focused role.