At our organization, our mission is to enhance healthcare affordability for patients and restore the fulfillment of practicing medicine for providers. As a physician-led company, we streamline administrative tasks and leverage predictive analytics and AI to empower our partner physician practices in delivering high-quality healthcare focused on outcomes and value.
Role Overview: RN Case Manager
As an RN Case Manager with us, you will play a pivotal role in partnering with clinical teams to provide complex case management and strengthen the connection between patients and primary care physicians/medical practice staff. You'll be responsible for assisting patients in achieving their highest-level wellness, particularly those with complex medical conditions, socio-economic challenges, and/or mental health co-morbidities.
Key Responsibilities
Conduct comprehensive assessments of healthcare and psychosocial needs of patients.
Develop, implement, and maintain individualized care plans aligned with internal protocols and accreditation standards.
Provide evidence-based clinical interventions based on care plan goals.
Collaborate with patient navigators to manage non-clinical aspects of care plans, such as appointments, transportation, and social determinants of health (SDOH) needs.
Conduct ongoing outreach to patients, monitor patient data, and adjust care plans as needed.
Collaborate with primary care physicians to develop patient-specific escalation plans for acute, non-emergent exacerbations of chronic conditions.
Educate patients on conditions and treatment options.
Serve as a patient advocate, facilitating access to clinical services and resources.
Follow up on service or resource referrals and maintain accurate documentation in electronic medical health records.
Utilize evidence-based clinical protocols, guidelines, and quality metrics.
Requirements
Licensed Registered Nurse in good standing.
3+ years of RN Case Management experience in an outpatient setting.
CCM certification preferred; must obtain CCM within recommended timeframe post-employment.
Supervisory Experience Preferred.
Excellent written and oral communication skills to interact empathetically with patients, families, and interdisciplinary teams.
Proficiency in computer skills, including multiple EMR and Case Management documentation systems.
Ability to meet accreditation and quality standards such as NCQA and HEDIS.
Preferred Qualifications
Bilingual in English and Spanish.
Compensation And Benefits
We offer a competitive compensation package, including comprehensive medical, dental, and vision plans, long and short-term disability, life insurance, and a 401k plan with a generous match. Our paid time off program includes paid holidays and flexible time to support work-life balance.
Equal Opportunity Employer
Diversity, inclusion, and belonging are fundamental to our values. We are committed to equal employment opportunity and embrace diversity in all aspects of our organization.
Employment Type: Full-Time
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Human Resources Services
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