RN Care/Case Manager

About the Job:

  1. Strictly telephonic
  2. Working as a case/care manager for all ages from Peds to Geriatric, coordinating services and identifying barriers to care (Medicare & Medicaid members).
  3. Keeping patients on track with care plans and educate them about their conditions and treatments.
  4. Could be contacting providers (doctors) to clarify information/plans and then relaying that info back to the patient.
  5. Flagging any potential issues and teach patients how to know when they should get themselves to a hospital.


Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care

  • Develop, assess and adjust, as necessary, the care plan and promote desired outcome
  • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
  • Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
  • Provide patient and provider education
  • Facilitate member access to community based services
  • Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
  • Actively participate in integrated team care management rounds
  • Identify related risk management quality concerns and report these scenarios to the appropriate resources
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • RN license
  • Several years of of clinical nursing experience in an acute care or other setting.
  • Proficiency in Excel & other MS products, email, etc.
  • Will not be writing things down in a chart and then inputting them later; they'll be talking on the phone with a patient or provider and data entering into the computer simultaneously. Don't need to be "experts," but need to be able to navigate around a computer while multitasking
  • Soft skills: need to be okay with change and not need a lot of individual attention. Good conflict resolution and team work skills

Hours for this Position:

M-F 8-5


Advantages of this Opportunity:

  • Competitive salary
  • Fun and positive work environment
  • Matching on 401K
  • Ticket into Managed Care


Want More Information?

• If you are interested in applying to this position, please contact Ashley Greene at 407-478-0332 ext 169 or email and click the Green I’m Interested Button to email your resume.


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