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
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