Senior Case Manager

Most of what makes American healthcare expensive isn’t medical care. It’s the machinery wrapped around it: middlemen taking a cut, fraud nobody stops, and billing systems designed to fight over payment instead of deliver care. The result is higher premiums, denied claims, surprise bills, and a system patients increasingly experience as adversarial.

Arlo is rebuilding health insurance for small businesses from first principles: making sure as much of every premium dollar as possible goes to care instead of getting absorbed by the system around it. We do that by identifying fraud earlier, steering members toward higher-quality and lower-cost care, automating operational overhead, and eliminating vendors whose business exists mostly to take a cut.

AI is the foundation that makes this work. We use it across underwriting, operations, clinical programs, and member experience to build an insurer that becomes more efficient as the technology improves.

We’re already operating at meaningful scale: profitable, hundreds of millions in premiums, tens of thousands of members covered, and growing quickly through brokers, employers, and partners. Backed by Upfront Ventures, 8VC, and General Catalyst, with a team from Palantir, YC companies, and longtime healthcare operators.

We're hiring our first Senior Case Manager to own the medical journeys of our members. You'll review claims data, prior authorizations, and admission/discharge feeds to spot members who need help, then work directly with them and their providers to make sure the right care happens at the right time. This is a role for an experienced RN who can think clinically, communicate warmly, and operate independently - equal parts clinical judgment and hands-on coordination.

You'll be a foundational member of our clinical team, with real influence over how we build our case management program from the ground up.

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  Review claims, prior auth requests, and ADT (admission/discharge/transfer) data to identify members who would benefit from case management

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  Conduct clinical assessments and build individualized care plans with members

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  Coordinate directly with PCPs, specialists, hospitals, and post-acute providers to ensure care plans are executed and gaps are closed

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  Support members through complex episodes — new diagnoses, hospitalizations, transitions of care, and chronic condition management

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  Partner with our utilization management workflows on medical necessity questions and appropriate level of care

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  Help us build the playbook: contribute to protocols, escalation pathways, and the tooling we use to do this work well

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  Document thoroughly and maintain compliance with applicable regulatory and accreditation standards

• Active, unrestricted RN license; multi-state compact license strongly preferred

• 5+ years of clinical nursing experience, with relevant experience in case management, utilization management, care coordination, or discharge planning

• Comfort reading and interpreting claims data, prior auth criteria (MCG/InterQual), and clinical documentation

• Strong communication skills — you can hold your own with a skeptical specialist and also meet a member where they are

• Self-directed; you can run your panel without someone over your shoulder

• Comfort working in a fast-moving environment where processes are still being built

• 30 minute call with Rachelle (Talent Lead)

• 45-minute introductory call with Karthik (Co-Founder/ COO & CTO)

• Take-home case study

• 45-min call with Jan-Felix (CEO/ Co-Founder)

• Onsite/ Virtual Onsite

• Reference Calls