Hybrid RN Case Manager

at PruittHealth

• Job title: RN Case Manager
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Macon, United States

About the role

• RN Case Manager overseeing clinical care management for community based long-term care population at PruittHealth. Advising and coordinating clinical care and support programs for optimal patient health.

Responsibilities

• Responsible for the oversight of clinical care management of community based long-term care population for PruittHealth Premier Dual Eligible Special Needs Plan (DSNP).
• Advise and coordinate clinical care across the health care continuum of both community based clinical providers as well as social support programs.
• Assist patients to achieve optimal health status utilizing the most cost-effective quality resources.
• Conduct in-home and telephonic assessment and data collection with patients and caregivers and document findings.
• Develop a case management care plan for each patient based on thorough history and clinical record review.
• Monitor the needs of patients and families on an ongoing basis.
• Provide care management and coordination to assure patient progress through the continuum of care.
• Coordinate hospital activities concerned with case management and discharge planning.
• Ensure the scheduling, coordination and completion of the inter-disciplinary team with primary care provider.

Requirements

• Advanced Nursing Diploma and/or college degree in nursing required.
• Bachelors (or higher) degree preferred.
• Minimum two years (full-time equivalent) direct clinical care experience required.
• Minimum three years industry experience in a managed care setting focused on experience in utilization review/case management and at least two years case management, home care or hospice experience strongly preferred.
• Minimum two years experience with long-term care population.
• Licensed Registered Nurse with current, unrestricted license in state of practice (Georgia) required.
• Certified Case Manager preferred – Mandatory to apply for CCM certification when eligible.
• Current CPR certification.
• Minimum of Class B driver’s license preferred.

Benefits

• Business travel may be required
• Ability to work in triage and/or disease management role if needed