Complex Case Manager: Chronic Care & Coordination

Kaiser Permanente; Atlanta (GA); Sur place; USD 85 000 - 110 000; Plein temps

Résumé du poste

KAISER in Atlanta, Georgia is seeking a Complex Case Manager (RN/LSW/UM background) to lead comprehensive, patient-centered case management for high-need members. You will perform assessments, develop plans of care, coordinate with inpatient/outpatient teams, and monitor progress with emphasis on self-management and quality outcomes.

Responsibilities include ensuring NCQA standards, documenting care, coordinating with social workers and providers, and conducting follow-ups, discharge planning,

Qualifications

• Minimum five (5) years of RN clinical nursing, social work, case management or utilization management (UM).
• Licensed RN in Georgia or equivalent clinical license.
• Experience with NCQA standards and care coordination.

Responsabilités

• Review referrals to the Complex Case Management Program within policy timelines.
• Assess member physical, psychosocial, environmental, financial, and health status.
• Develop a comprehensive care plan with interventions and goals.
• Coordinate plan of care with treating practitioners and educate member/caregiver.
• Implement and monitor care plans; adjust as needed for progress.
• Schedule follow-ups and reassess member status and outcomes.
• Refer to other KPGA programs and community resources as needed.
• Document all case management interactions in the medical record.
• Ensure quality of care and monitor costs and utilization.

Connaissances

RN Clinical Nursing

Social Work

Case Management

UM/Utilization Management

Medicare/Medicaid Knowledge

ICD10/CPT4 Coding

Communication Skills

Computer Literacy

Formation

Georgia RN License

Bachelor's in Nursing

Outils

EMR Systems

Description du poste

KAISER in Atlanta, Georgia is seeking a Complex Case Manager (RN/LSW/UM background) to lead comprehensive, patient-centered case management for high-need members. You will perform assessments, develop plans of care, coordinate with inpatient/outpatient teams, and monitor progress with emphasis on self-management and quality outcomes.

Responsibilities include ensuring NCQA standards, documenting care, coordinating with social workers and providers, and conducting follow-ups, discharge planning,