RN Case Manager

American Health Partners; Atlanta (GA); On-site; USD 60,000 - 100,000; Full time

Job summary

American Health Partners seeks an RN Case Manager in Atlanta. You will be responsible for managing care coordination for Medicare Advantage members, evaluating patient needs, and ensuring quality care. Join a supportive team where you can grow and advance your nursing career, benefiting from competitive pay and comprehensive healthcare options.

Benefits

Annual performance wage increases

401k retirement plan with a company match

Medical, dental and vision insurance

Paid time off

Continuing Education opportunities

Career Advancement Opportunities

Qualifications

• Minimum of 2 years of experience in clinical nursing.
• Managed care experience required.
• Experience in case management preferred.

Responsibilities

• Manage daily case management strategies for patients.
• Coordinate with healthcare team to evaluate patient care plans.
• Perform Health Risk Assessments for members.

Skills

Communication

Teamwork

Adaptability

Education

Graduate of an accredited RN program

Bachelor's Degree

Job description

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Come Grow with Us!

Come Grow with Us!

TruHealth is a division of American Health Partners, a multifaceted company with operations in multiple states. We own nursing homes, health plans for Medicare beneficiaries living in long-term care facilities, as well as divisions offering psychiatric care, home health, hospice, rehabilitation and specialty pharmacy services.

We offer competitive pay, generous benefits and advancement opportunities. We believe in caring for the people that care for patients and have many reward and recognition programs to highlight the awesome and important work our clinicians do each and every day.

The RN Case Manager is primarily responsible for the daily management and support of the Case Management strategies for care coordination for a group of members who are associated with a Medicare Advantage plan. Visit (in person and/or telephonic) patients to ensure proper nursing care. Interview or correspond with physicians to correct errors or omissions and to investigate questionable claims. Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care plans.

This position requires an individual who is a self-starter and team player, has the ability to manage multiple priorities, work with minimal supervision on assigned projects and activities, and demonstrates excellent communication and presentation skills. This individual must be able to adapt quickly to change and be able to collaborate with multiple teams

Here Are a Few Of Our Benefits

• Annual performance wage increases
• 401k retirement plan with a company match
• Medical, dental and vision insurance
• Paid time off
• UKG Wallet – access your pay faster!
• Holiday pay
• Telehealth through 98point6 – free to all employees
• Continuing Education opportunities
• Career Advancement Opportunities
  
  

Qualifications/Requirements

• Minimum of 2 years of experience in clinical nursing or rehabilitation for the geriatric population.
• 2-years managed care experience required.
• Minimum of 3-5 years’ experience doing case management in a managed care environment preferably with a managed care organization or like facility, Preferred.
  
  

Essential Functions

• 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.
• Evaluates, coordinates, and plans patient care in collaboration with an interdisciplinary health team; reassesses and revises plans of care in collaboration with other members of the health care team.
• Provides patient/family education based on identified learning needs utilizing available teaching resources
• Provides education based on identified learning needs utilizing available teaching resources to members of the Home/Facility staff as needed.
• Coordinates outpatient discharge planning based on patient needs, clinical circumstances and benefit coverage.
• Participates in all Managed Care related audits; generates, maintains and tracks periodic and annual reports/documents via MS Office program, e-mails to support Care Coordination program.
• Performs improvement projects involving development of monitoring/collection tools, review of medical records, data entry, analysis, and preparation of audit findings and reports.
• Participates in patient care conferences, committee meetings, staff development and educational programs to increase or maintain professional competency.
• Correctly applies medical management criteria.
• Researches clinical questions from employers, members and payers as required.
• Educate members on health access options.
• Responds, manages, and resolves day-to-day problems presented in care coordination and communicates effectively with the Facility/Home.
• Other duties as assigned.
  
  

Education

• Graduate of an accredited RN program.
• Bachelor’s Degree preferred.
  
  

Licensure/Certifications

• Current license to practice as a register nurse in assigned state.
• Current CCM license, Preferred
• CPR for Healthcare Professionals certification.
• Current valid driver’s license.
• Current motor vehicle insurance.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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