RN Care Coordinator - Medicare Advantage

American Health Partners; Mount Sterling (KY); On-site; USD 65,000 - 82,000; Full time

Benefits offered by this job

Annual performance wage increases

401k retirement plan with a company

Medical, dental and vision insurance

Life insurance – $50,000

Paid time off

UKG Wallet – access your pay faster

Holiday pay

Telehealth through 98point6

Continuing Education opportunities

Career Advancement Opportunities

Job summary

American Health Partners is seeking an experienced RN Case Manager to oversee care coordination for Medicare Advantage members. You will visit patients in person or by telehealth to ensure appropriate nursing care and collaborate with physicians to optimize care plans.

The role requires strong communication, ability to manage multiple priorities, and teamwork across several clinical groups. A valid RN license and CCM certification are preferred; Bachelor's degree is a plus.

Qualifications

• Graduate of an accredited RN program.
• 2+ years nursing or geriatric rehabilitation experience.
• 2+ years managed care experience required.
• 3-5 years case management in managed care environment preferred.
• Current RN license in assigned state.
• CCM license preferred.
• CPR for Healthcare Professionals certification.
• Current valid driver’s license and insurance.

Responsibilities

• Complete Health Risk Assessments for members as assigned.
• Initiate, update and/or revise care plans as needed.
• Maintain a case load of patient as assigned.
• Collaborate with interdisciplinary health team to plan, implement and evaluate care.
• Educate patients and families on identified learning needs.
• Coordinate outpatient discharge planning based on patient needs.
• Participate in managed care audits and generate reports via MS Office.
• Lead improvement projects involving data collection and audits.
• Participate in care conferences, staff development and education.
• Apply medical management criteria and coordinate with facilities.

Skills

RN licensure

Case management

Managed care

Interdisciplinary collaboration

Communication skills

CPR certification

Education

RN program graduate

Bachelor's degree preferred

Job description

American Health Partners is seeking an experienced RN Case Manager to oversee care coordination for Medicare Advantage members. You will visit patients in person or by telehealth to ensure appropriate nursing care and collaborate with physicians to optimize care plans.

The role requires strong communication, ability to manage multiple priorities, and teamwork across several clinical groups. A valid RN license and CCM certification are preferred; Bachelor's degree is a plus.