Help us elevate our patient care to a whole new level!
Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models.
Community Care Case Manager use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs.
Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care.
Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes.
Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person.
Prepares all required documentation of case work activities as appropriate.
Monitors member/client progress toward desired outcomes through assessment and evaluation.

Candidate must have active and unrestricted Compact Registered Nurse (RN) Licensure in Alabama, Arkansas, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, Georgia, or Florida
3+ years of clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac, Home Health) with Medicare members
2+ years of case management, discharge planning and/or home health care coordination experience
Proficiency with standard corporate software applications, including Microsoft Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
Able to work in a fast paced high volume environment and utilize time management and prioritization skills.
Efficient and effective computer skills including navigating multiple systems and keyboarding
Bilingual
Spanish (Preferred)
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills
Certified Case Manager
National professional certification (CRC, CDMS, CRRN, COHN, or CCM) (Preferred)

Case Manager – Registered Nurse

Key skills