Why does this seem impossible?

You have great credentials for role. I'm curious... why not in hospital setting. That is where I work; the pay is great, we are salaried, and have few on call + no travel. I recommend you try the different CM web sites, many of them have places to look for open positions. If you want Ins company, you could do telephonic CM from your home office... You might try looking on the web, and typing in Case Mangement positions in your query, and see what hits you get.