Post-Acute RN Case Manager — Care Continuum Expert

PruittHealth; Norcross (GA); On-site; USD 75,000 - 95,000; Full time

Job summary

PruittHealth in Georgia, NORCROSS, is seeking an experienced RN Case Manager to ensure the continuation of medically necessary services post-acute care. You will navigate CMS and commercial insurance requirements to coordinate care across settings.

Ideal candidates hold GA RN licensure, a minimum of 3 years of clinical experience, and familiarity with home health or skilled nursing. Proficiency in Word/Excel/Outlook is expected, with strong communication and organization skills.

Qualifications

• BSN preferred
• Currently licensed Registered Nurse in the state of GA.
• A minimum of 3-years of clinical experience is required.
• Home Health Care and or skilled nursing industry experience highly preferred.
• RN Case Management experience preferred.
• Must be proficient in the use of computer applications for daily use.
• Highly proficient in Microsoft Word, Intermediate Excel and Outlook required

Responsibilities

• Understands CMS and Commercial Insurance requirements to ensure regulatory compliance.
• Knowledge of medical necessity review guidelines for commercial, Medicare, and Medicaid products.
• Uses insurance criteria and regulations to expedite appropriate use of resources.
• Communicates effectively via phone and email with internal and external customers.
• Maintains strong organization and multitasking abilities for success in this role.

Skills

RN licensed

Case management

Communication

Computer skills

Education

BSN preferred

GA RN license

Tools

Microsoft Word

Excel

Outlook

Job description

PruittHealth in Georgia, NORCROSS, is seeking an experienced RN Case Manager to ensure the continuation of medically necessary services post-acute care. You will navigate CMS and commercial insurance requirements to coordinate care across settings.

Ideal candidates hold GA RN licensure, a minimum of 3 years of clinical experience, and familiarity with home health or skilled nursing. Proficiency in Word/Excel/Outlook is expected, with strong communication and organization skills.