RN Case Manager
PruittHealth
full-time
Posted on:
Location Type: Hybrid
Location: Macon • United States
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About the role
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical care managementcase managementutilization reviewdata collectioncare plan developmentpatient assessmentdischarge planninginter-disciplinary team coordinationlong-term carehome care
Soft Skills
communicationcoordinationadvisingmonitoringpatient advocacyorganizational skillsproblem-solvingcollaborationleadershipempathy
Certifications
Licensed Registered NurseCertified Case ManagerCPR certification