Registered Nurse Case Manager

Job Title: Registered Nurse (RN) Case Manager – Purchased Referred Care (PRC) Job Summary We are seeking an experienced Registered Nurse (RN) Case Manager with direct Indian Health Service (IHS) Purchased/Referred Care (PRC) experience to support care coordination, referral management, and utilization review services. The ideal candidate will have a strong understanding of IHS PRC policies, eligibility requirements, and case management processes while ensuring quality patient care and appropriate resource utilization. Key Responsibilities Manage and coordinate patient referrals through the IHS Purchased/Referred Care (PRC) program. Review and evaluate medical referrals for medical necessity, eligibility, and compliance with PRC guidelines. Collaborate with providers, care teams, patients, and external healthcare organizations to ensure timely access to services. Monitor patient cases and maintain accurate documentation in accordance with IHS and facility standards. Conduct utilization review and case management activities to optimize patient outcomes. Educate patients and families regarding available healthcare services and treatment plans. Ensure compliance with all federal, state, tribal, and organizational regulations. Required Qualifications Active, unrestricted Registered Nurse (RN) license. Minimum 2 years of RN Case Management experience. Required: Direct IHS Purchased/Referred Care (PRC) experience. Knowledge of IHS policies, referral management, and utilization review processes. Strong communication, organizational, and documentation skills. Proficiency with electronic health records (EHR) systems. #INDRNS Pay: $2,600.00 - $2,800.00 per week Benefits: Referral program Experience: Case management: 2 years (Required) License/Certification: RN License (Required) BLS Certification (Required) Work Location: In person