RN Care Manager - Case Management

Who We Are At Vitruvian Health, we serve with compassion. As the leading healthcare system for northwest Georgia and southeast Tennessee, we are committed not only to strengthening the health of our communities, but also to supporting the growth, success, and well‑being of every team member. Our Legacy Formerly Hamilton Health Care System, Vitruvian Health is built on a legacy of trust, innovation, and exceptional care.

With more than 80 access points across the region—including Hamilton Medical Center and Bradley Medical Center—you’ll have the opportunity to be part of something bigger: a connected, mission‑driven team making a difference every day. Our Values Our core values— Professionalism, Respect, Integrity, Diversity, and Excellence (PRIDE) —guide every interaction and decision. We believe in empowering our people, celebrating what makes us unique, and delivering care that reflects the heart of our mission.

Your Career With Us Join us and build a meaningful career where you’re valued, inspired, and supported to make a real impact. Excellence. Every person.

Every time. Practices with minimum supervision from another licensed professional and is able to perform the following components of case management according to the Case Management Society of America Standards: assessment, facilitating, planning, advocating, , monitoring, evaluation, and outcomes. In collaboration with all healthcare professionals involved, this position is also able to demonstrate the above components within the following core activities: coordination and service delivery, physical and psychological factors, benefit systems, cost benefit systems, cost benefit analysis, case management concepts and community resources.

The case manager facilitates communication and coordinates between all members of the healthcare team involving the patient and family in the decision-making process in order to minimize the fragmentation of the healthcare delivery system. The case manager is a leader in effecting change to improve the quality of patient care and reduce the cost of services on a care by care basis. The case manager understands financial implications of care in today’s healthcare environment such as (but not limited to): requirements for prior approval by payer; cares which would benefit from alternative care; analysis of necessary medical services for cost containment; healthcare plans for appropriateness; home health/hospice resources; healthcare delivery systems; DRG system; care mix index; managed care and capitation.

Responsibilities also include collaboration with the Utilization Review Team to assist with the admission process for non-elective, emergency inpatient admissions and outpatient observation stays; monitoring observation stays at the end of 23 hours for possible inpatient admission or discharge planning; ensuring that all patients are screened against Interqua/Milliman or other appropriate criteria and assist the physician in identifying alternative methods of care when criteria are not met. Works closely with the Physician Advisor on cases that do not meet admission criteria or continued stay criteria. Provides discharge planning services, such as Home Health, DME, SNF and IPR referrals to facilitate a timely discharge plan.

The case manager will work in collaboration as a team to ensure timely provision of services. The case manager will be responsible for identifying performance improvement opportunities and assist with data collection. The case manager will assist in program development and implementation for specific programs and plans of patient care such as clinical pathway, population specific and disease management initiatives.

The case manager will coordinate the care of an average care load of 20-25 patients per day.

Education

Graduate of an accredited School of Nursing.

Licensure

Current RN Nursing license in the State of Tennessee. AHA BLS CPR required.

Certification

Certification in Case Management is desired.