About the role

  • RN Case Manager overseeing clinical care management for community based long-term care population at PruittHealth. Advising and coordinating clinical care and support programs for optimal patient health.

Responsibilities

  • Responsible for the oversight of clinical care management of community based long-term care population for PruittHealth Premier Dual Eligible Special Needs Plan (DSNP).
  • Advise and coordinate clinical care across the health care continuum of both community based clinical providers as well as social support programs.
  • Assist patients to achieve optimal health status utilizing the most cost-effective quality resources.
  • Conduct in-home and telephonic assessment and data collection with patients and caregivers and document findings.
  • Develop a case management care plan for each patient based on thorough history and clinical record review.
  • Monitor the needs of patients and families on an ongoing basis.
  • Provide care management and coordination to assure patient progress through the continuum of care.
  • Coordinate hospital activities concerned with case management and discharge planning.
  • Ensure the scheduling, coordination and completion of the inter-disciplinary team with primary care provider.

Requirements

  • Advanced Nursing Diploma and/or college degree in nursing required.
  • Bachelors (or higher) degree preferred.
  • Minimum two years (full-time equivalent) direct clinical care experience required.
  • Minimum three years industry experience in a managed care setting focused on experience in utilization review/case management and at least two years case management, home care or hospice experience strongly preferred.
  • Minimum two years experience with long-term care population.
  • Licensed Registered Nurse with current, unrestricted license in state of practice (Georgia) required.
  • Certified Case Manager preferred – Mandatory to apply for CCM certification when eligible.
  • Current CPR certification.
  • Minimum of Class B driver’s license preferred.

Benefits

  • Business travel may be required
  • Ability to work in triage and/or disease management role if needed

Job title

RN Case Manager

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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