RN Case Manager – Medicare Advantage Care Coordination

American Health Partners; Ashland (KY); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Annual wage increases

401k retirement plan with companymatch

Medical, dental and vision insurance

$50,000 life insurance paid by company

Paid time off

UKG Wallet—get paid faster

Holiday pay

Telehealth through 98point6

Continuing Education opportunities

Career Advancement Opportunities

Job summary

American Health Partners is seeking an RN Case Manager to support care coordination for a Medicare Advantage plan. You will visit patients, coordinate with physicians, and develop/adjust care plans with an interdisciplinary team.

The role requires self-motivation, teamwork, and strong communication skills to manage multiple priorities and adapt to change across departments. Experience in managed care and geriatric nursing is preferred.

Qualifications

• Minimum 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 preferred.

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.
• Collaborates with an interdisciplinary health team to plan, implement and evaluate patient care plans.
• Provides patient/family education using available teaching resources.
• Coordinates outpatient discharge planning based on patient needs, clinical circumstances and benefit coverage.
• Performs improvement projects involving monitoring/collection tools and audits.
• Participates in patient care conferences and staff development to maintain competency.
• Educate members on health access options.
• Responds and resolves day-to-day problems presented in care coordination.

Skills

Clinical nursing

Geriatric care

Managed care experience

Case management

Education

Graduate of an accredited RN program

Bachelor's Degree preferred

Job description

American Health Partners is seeking an RN Case Manager to support care coordination for a Medicare Advantage plan. You will visit patients, coordinate with physicians, and develop/adjust care plans with an interdisciplinary team.

The role requires self-motivation, teamwork, and strong communication skills to manage multiple priorities and adapt to change across departments. Experience in managed care and geriatric nursing is preferred.