RN Complex Care Manager: Lead Care Coordination & Transitions

Hamilton Medical Center, Inc.; United States; On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

403(b) Matching

Dental insurance

Employee assistance program

Employee wellness program

Employer paid Life and AD&D insurance

Employer paid Short and Long-Term Disb

Flexible Spending Accounts

Job summary

Vitruvian Health is seeking a Complex Case Manager to coordinate admission, treatment planning, and discharge for diverse patient populations. The role emphasizes collaboration with the UM team and physicians to ensure appropriate, cost-effective care lasting across the continuum.

Ideal candidates are RNs with 3–5 years of case management or utilization review experience, strong communication skills, and proficiency with care management software.

Qualifications

• Graduate of an accredited School of Nursing.
• Current RN licensure in Georgia (state-specific license where applicable) with BSN preferred.
• BLS CPR certification required; Care Management certification desired.

Responsibilities

• Coordinate admission and discharge planning for complex cases.
• Collaborate with UM team to apply Interqual/Milliman criteria where appropriate.
• Support physician in identifying alternative care options when criteria are not met.
• Lead care management activities including assessment, planning, advocacy, and evaluation.
• Communicate with patients and families to minimize fragmentation of care.

Skills

RN licensure

BSN preferred

BLS CPR

Utilization Review

Case Management

Computer skills

Interpersonal communication

teaching abilities

Medicare/Medicaid knowledge

Team collaboration

Education

Graduate of an accredited School of Nursing

Tools

Care management software

Interqual/Milliman criteria

Job description

Vitruvian Health is seeking a Complex Case Manager to coordinate admission, treatment planning, and discharge for diverse patient populations. The role emphasizes collaboration with the UM team and physicians to ensure appropriate, cost-effective care lasting across the continuum.

Ideal candidates are RNs with 3–5 years of case management or utilization review experience, strong communication skills, and proficiency with care management software.