Remote Registered Nurse Case Manager

Job Description

Job Description

Salary : $80k to $85k per year

WHO IS GUIDEHEALTH?

At Guidehealth, our mission is to enhance healthcare affordability for patients and restore the fulfillment of practicing medicine for providers.

As a physician-led company, we recognize that streamlining administrative tasks and harnessing the power of predictive analytics and AI enable our partner physician practices to prioritize delivering high-quality healthcare focused on outcomes and value.

Driven by empathy, we empower physicians to anticipate the needs of patients requiring more attention, strengthen connections between patients and physicians with virtually-embedded Healthguides, and leverage AI and analytics to proactively avoid preventable events.

This approach results in increased levels of patient and practice engagement, ultimately leading to more significant positive impacts on patients.

Join us as we put healthcare on a better path!!

As an RN Case Manager you will be partnering with clinical teams to provide complex case management and strengthen the connection between the patient and the primary care physician / medical practice staff.

The Registered Nurse (RN) Case Manager is responsible for assisting patients to achieve their highest-level wellness. You will be Case Managing a specific patient population which includes complex medical conditions, social-economic and / or mental health co-morbidities.

The RN Case Manager will optimize the patient’s health status through assessment, planning, implementation, coordination, monitoring, and evaluation of the options and services available to the patient.

The RN Case Manager will collaborate with approximately 5 patient care navigators and other members of a patient’s care team to achieve optimal quality, clinical, and financial outcomes.

This is a remote position that will require travel as needed (10%-15%) to clinical sites in the Atlanta, GA area including Atlanta, Columbus, GA, Roswell, GA, Johns Creek, GA, and Sugar Hill GA.

At this time we are only considering applicants in the local area.

WHAT YOU’LL BE DOING

• Comprehensively assessing the healthcare and psychosocial needs of patients
• Reviewing and amending patient navigator interviews with the patient.
• Developing, implementing, and maintaining individualized care plans in accordance with all internal protocols and accreditation standards.
• Providing evidence-based clinical interventions based upon the individualized care plan goals.
• Partnering with patient navigator to manage non-clinical elements of care plan, such as making appointments, arranging transportation or food services, or other SDOH / non-medical patient needs.
• Providing ongoing outreach to patients, continuously monitoring patient data and adjusting plan of care accordingly.
• Developing with the PCP, patient specific escalation plans in the event of an acute, but non-emergent, exacerbation of key chronic conditions.
• Providing education regarding conditions and treatment options.
• Serving as an advocate for the patient and assist with accessing and engaging with services / resources that require clinical licensing, training, or knowledge.
• Following up on service or resource referrals
• Maintaining up to date documentation in the electronic medical health record as defined by protocol.
• Utilizing evidence-based clinical protocols and guidelines along with defined quality metrics

WHAT YOU'LL NEED TO HAVE

• Licensed Registered Nurse in good standing
• 3+ years of RN Case Management experience in outpatient setting
• CCM certification preferred, must obtain CCM within (recommend 1 years) of employment.
• Supervisory experience preferred
• Excellent written an oral communication skills to empathetically interact with patients, families, and the interdisciplinary team
• Excellent computer skills including the ability to learn multiple EMR and Case Management documentation systems.
• Ability to meet accreditation and quality standards including but not limited to NCQA and HEDIS

WOULD LOVE FOR YOU HAVE

Bilingual in English and Spanish preferred

COMPENSATION

Guidehealth’s compensation structure includes more than just base salary. We believe in providing world-class benefits 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 that focuses on meeting the demands of the position and our clients, while providing the balance that our employees need.

The base pay range for this role is between $80k to 85k per year paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to : skill set, years of relevant experience, education, location, and licensure / certifications.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT

Diversity, inclusion, and belonging is at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.

Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.

This position is responsible for following all Security policies and procedures in order to protect all PHI under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties.

For any security-specific roles, the responsibilities would be further defined by the hiring manager.

remote work