Nurse Case Manager (RN)

Your Health; West Columbia (SC); On-site; USD 70,000 - 95,000; Full time

Job summary

Your Health in United States seeks a Nurse Case Manager to lead care teams and coordinate services within the assigned region. You will guide nurses, social workers, therapists, and health coaches to deliver high-quality care, monitor productivity, and support cost-reduction initiatives across the patient population.

The role requires strong teamwork, regulatory knowledge, and effective communication with regional leadership to optimize care delivery and ensure patient satisfaction.

Qualifications

• Leads care teams to ensure quality patient care and efficient service delivery.
• Understands and enforces compliance with applicable regulations.
• Partners with regional leadership to support care group objectives.

Responsibilities

• Lead and manage a care team comprising nurses, social workers, therapists, and health coaches.
• Engage with patients to explain the care model and disease management strategies.
• Monitor care team productivity to ensure timely patient assessments and visits.
• Collaborate on primary care billing optimization to reduce unnecessary spending.
• Handle service recovery and resolve conflicts or complaints.
• Review programs with leadership to ensure timely, appropriate care delivery.
• Oversee scheduling by case managers to maintain structured provider timetables.
• Foster two-way communication between staff, administration and regional teams.
• Provide training and supervision to staff on responsibilities, protocols, and systems.

Skills

Team Leadership

Patient Care

Productivity Management

Billing Optimization

Communication

Job description

General Description

The role of the Nurse Case Manager t is responsible for leading and managing the care teams within their assigned region. The position will be responsible for staff productivity, ensuring the provision of quality care services and the reduction of unnecessary healthcare costs. The Nurse Case Manager will support a culture of compliance with all applicable federal and state regulations. This position works closely and collaboratively with the members of the care group and with regional leadership.

Areas of Responsibility

A successful Nurse Case Manager will be able to perform these essential duties and responsibilities. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.

The following is a list of essential functions, which may be subject to change at any time and without notice. Management may assign new duties, reassign existing duties, and/or eliminate function(s).

• Team Leadership: Lead and manage a care team consisting of healthcare professionals, including but not limited to nurses, social workers, therapists, and health coaches.
• Patient Care: Actively engage with patients to help them understand the Company’s care model, their diseases, and disease management strategies.
• Productivity Management: Monitor and enhance the productivity of your care team to ensure that all necessary assessments and patient visits are conducted efficiently.
• Billing Optimization: Collaborate with your team to optimize primary care billing, aiming for it to constitute 15% of the total allotment for your group of patients. This optimization should contribute to a reduction in unnecessary medical spending.
• Service Recovery: Collaboration for conflict, complaint management and resolution for any concerns.
• Consistent program review with leadership to ensure right care at right time delivery of services & support to patients, families, facilities, and other healthcare partners.
• Scheduling Management and Oversight: Responsible for managing and overseeing the scheduling process completed by case managers to ensure providers and other disciplines have a well-structured and effective schedule.
• Promote effective two-way communication between employees supervised, administration and team members within the region.
• Training and Supervision: Provide training and guidance to staff, ensuring they understand their job responsibilities, goals, protocols, customer service standards, and proper use of company’s software systems.
• Participate in interviews and hiring staff when necessary.
• Administrative Functions: Perform general administrative tasks and support other staff as needed.
• Leverage technology platforms to enhance patient care and staff productivity.
• Participate in coaching calls.
• Perform other duties as requested or required, in the sole discretion of the Company.

Mission Expectations

• Take responsibility for own work in completing tasks. Assist others so that the resources, assistance, or support is provided to achieve success in their daily work.
• Communicate, endorse, and demonstrate the Company’s mission, vision, and values.
• Prompt and regular attendance.
• Adhere to standards of behavior, dress code including name tag and approved uniform, personnel department, and company policies.
• Attend in-services and meetings on a regular basis.
• Promote a culture of outstanding customer service and strive to enhance patient experience at all times.
• Must be available during normal work hours (unless previously approved by direct supervisor). Additional hours may be required to complete normal business functions and/or projects.
• Must possess the ability to deal tactfully with patients, employees, management, visitors, government agencies, and the general public and maintain an open-door policy for all employees.
• Must possess the ability to make independent decisions when circumstances warrant.