Remote Plan Case Manager: Care Coordination & Advocacy

Pruitthealth Corporation; Athens (GA); On-site; USD 65,000 - 95,000; Full time

Job summary

Plan Case Manager at PruittHealth Premier is responsible for oversight of clinical care management for the DSNP population. This role operates primarily remotely with limited in-home visits across Georgia, coordinating care with clinicians, social supports and providers to optimize health outcomes and cost effectiveness.

The RN must have education and licensure, two+ years in managed care or case management, and strong communication skills to support patients and families while navigating

Qualifications

• Advanced Nursing Diploma or Bachelor's in nursing required
• Holds/eligible for Georgia RN license
• CCM preferred – mandatory to pursue CCM if eligible

Responsibilities

• Perform in-home and telephonic assessments and document findings
• Develop case management care plans based on reviews and guidelines
• Monitor patient needs and adjust plans of care
• Coordinate with Plan Care Navigator and hospital activity for care transitions
• Educate patients and support self-management and adherence
• Collaborate with pharmacists for medication management and compliance
• Ensure timely inter-disciplinary team meetings and documentation
• Maintain compliance with HIPAA and regulatory standards

Skills

Remote work adaptability

Communication skills

Care coordination

Time management

Privacy & HIPAA

Independent work

Education

Advanced Nursing Diploma/BSN

RN license in GA

Tools

Care Management Platforms

Job description

Plan Case Manager at PruittHealth Premier is responsible for oversight of clinical care management for the DSNP population. This role operates primarily remotely with limited in-home visits across Georgia, coordinating care with clinicians, social supports and providers to optimize health outcomes and cost effectiveness.

The RN must have education and licensure, two+ years in managed care or case management, and strong communication skills to support patients and families while navigating