Remote RN Case Manager

Guidehealth; Denver (CO); Remote; USD 60,000 - 100,000; Full time

Job summary

Join a forward-thinking healthcare company as an RN Case Manager, where you will play a crucial role in enhancing patient wellness through comprehensive case management. This innovative firm emphasizes operational excellence and patient-centered care, allowing you to collaborate with clinical teams and navigate complex medical conditions. You will develop personalized care plans, advocate for patients, and ensure they receive the necessary resources and support. With a fully remote work environment and a commitment to employee well-being, this role offers the opportunity to make a significant impact while enjoying a supportive and flexible workplace culture.

Benefits

Comprehensive Medical, Dental, and Vision Plans

401(k) with 3% employer match

Life and Disability Insurance

Employee Assistance Program (EAP)

Flexible Time Off

Qualifications

• 3+ years of RN Case Management experience in outpatient settings.
• Licensed Registered Nurse in good standing.

Responsibilities

• Assessing healthcare and psychosocial needs of patients.
• Developing and maintaining individualized care plans.

Skills

Empathetic Communication

Clinical Assessment

Care Plan Development

Patient Advocacy

EMR Documentation

Education

Registered Nurse License

CCM Certification (preferred)

Tools

EMR Systems

Case Management Documentation Systems

Job description

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WHO IS GUIDEHEALTH?

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.

Job Description

As an RN Case Manager, you will be partnering with clinical teams to provide complex case management and strengthen the connection between the patient and the primary care physician/medical practice staff. The Registered Nurse (RN) Case Manager is responsible for assisting patients to achieve their highest-level wellness. You will be Case Managing a specific patient population which includes complex medical conditions, social-economic and/or mental health co-morbidities. The RN Case Manager will optimize the patient’s health status through assessment, planning, implementation, coordination, monitoring, and evaluation of the options and services available to the patient. The RN Case Manager will collaborate with approximately 5 patient care navigators and other members of a patient’s care team to achieve optimal quality, clinical, and financial outcomes.

What You’ll Be Doing

• Comprehensively assessing the healthcare and psychosocial needs of patients
• Reviewing and amending patient navigator interviews with the patient.
• Developing, implementing, and maintaining individualized care plans in accordance with all internal protocols and accreditation standards.
• Providing evidence-based clinical interventions based upon the individualized care plan goals.
• Partnering with patient navigator to manage non-clinical elements of care plan, such as making appointments, arranging transportation or food services, or other SDOH/non-medical patient needs.
• Providing ongoing outreach to patients, continuously monitoring patient data and adjusting plan of care accordingly.
• Developing with the PCP, patient specific escalation plans in the event of an acute, but non-emergent, exacerbation of key chronic conditions.
• Providing education regarding conditions and treatment options.
• Serving as an advocate for the patient and assist with accessing and engaging with services/resources that require clinical licensing, training, or knowledge.
• Following up on service or resource referrals
• Maintaining up to date documentation in the electronic medical health record as defined by protocol.
• Utilizing evidence-based clinical protocols and guidelines along with defined quality metrics.

What You’ll Need To Have

• Licensed Registered Nurse in good standing in the State of Georgia or Compact license
• 3+ years of RN Case Management experience in outpatient setting
• CCM certification preferred, must obtain CCM within 1 year of employment.
• Supervisory experience preferred
• Excellent written and oral communication skills to empathetically interact with patients, families, and the interdisciplinary team
• Excellent computer skills including the ability to learn multiple EMR and Case Management documentation systems.
• Ability to meet accreditation and quality standards including but not limited to NCQA and HEDIS.

BENEFITS:

While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:

• Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
• Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.
• Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
• Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.
• Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
• Take Time for Yourself: We offer Flexible Time Off