RN Case Manager — Complex Care Coordination

Health One Alliance, LLC; Dalton (GA); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

401K with Match

Health Insurance

Paid Time Off

Life Insurance

Job summary

HealthOne is seeking a Case Manager to oversee member care and progress for high-risk cases. You will collaborate with members, providers, and internal teams to ensure effective care delivery and appropriate benefits utilization.

Requirements include 3 years of clinical experience, 5 years in healthcare, and an active RN license in Georgia or equivalent. CCM certification is preferred or must be obtained within 2 years of hire. Strong computer skills are essential.

Qualifications

• 3 years clinical experience required.
• 5 years -experience in the health care industry
• Has current Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire
• PC Skills required (Basic Microsoft Office and E-Mail)
• Registered Nurse (RN) with active license in the state of Georgia

Responsibilities

• Supports utilization management functions for more complex and non-routine cases as needed
• Serves as a liaison between members, providers, and internal/external customers in coordination of health care delivery and benefits programs
• Oversees highly complex cases identified through various mechanisms to ensure effective implementation of interventions
• Performs essential activities of case management including assessment, planning, implementation, coordinating, monitoring of outcomes and evaluation of member’s needs
• Maintains regular and predictable attendance
• Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice

Skills

Clinical experience

RN license GA

CCM credential

Microsoft Office

Education

RN degree

Tools

PC Skills

Microsoft Office

Job description

HealthOne is seeking a Case Manager to oversee member care and progress for high-risk cases. You will collaborate with members, providers, and internal teams to ensure effective care delivery and appropriate benefits utilization.

Requirements include 3 years of clinical experience, 5 years in healthcare, and an active RN license in Georgia or equivalent. CCM certification is preferred or must be obtained within 2 years of hire. Strong computer skills are essential.