We hire in 46 of the United States. We do not hire in Alaska, California, Hawaii or Washington D.C. for Work From Home.
RN Nurse Case Manager – Atlanta Buckhead Area
Your Talent. Our Vision. This company is a proud of its powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve.
Nurse Case Manager I, II or Senior level.
These positions will be located in our Buckhead office in Atlanta. Telecommuting is not an option for these positions at this time. The hours of operation for this position are M-F between the hours of 8am-8pm (40 hour week).
Responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically for discharge planning.
Qualified candidate will possess current unrestricted Georgia RN license and 3+ years of clinical experience.
- Ensures member access to services appropriate to their health needs.
- Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
- Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
- Coordinates internal and external resources to meet identified needs.
- Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
- Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
- Negotiates rates of reimbursement, as applicable.
- Assists in problem solving with providers, claims or service issues.
- Multi-state licensure is required if this individual is providing services in multiple states.
- Certification as a Case Manager is preferred.
We are currently having individuals apply online – department may interview some prior, but they are planning to review and invite individuals for a large on-site interviewing event on July 15th with an August start date (probably mid-August – sorry do not have the date).
* The above job descriptions and listed requirements can often change based on current Employer need and new projects. Your assigned job counselor will provide you with the most up-to-date job information.
No Phone calls – All applications must be submitted using our pre-qualify form: http://myemploymentoptions.