Health Home Registered Nurse Case Manager

Job Summary

We are seeking a dedicated and compassionate Health Home Registered Nurse Case Manager to join our dynamic healthcare team. In this vital role, you will coordinate comprehensive care plans for patients with complex health needs, ensuring seamless access to services and optimal health outcomes. Your expertise in clinical case management, patient assessment, and interdisciplinary collaboration will drive personalized care delivery in diverse settings, including home health, outpatient clinics, and hospital environments. This position offers an exciting opportunity to make a meaningful difference in patients' lives through proactive management and compassionate support.

Responsibilities

• Conduct thorough patient assessments, including vital signs, medical history review, and physiological evaluations to determine individual care needs.
• Initiate and maintain Authorizations for LTSS clients.
• Complete required DMAS forms (97, 99, 98R, PartV, etc.)
• Create Individualized Support Plans for clients.
• Develop and implement personalized care plans in collaboration with healthcare professionals, ensuring alignment with patient goals and health regulation policies.
• Manage patient cases across various settings such as hospital, post-acute care, outpatient clinics, and home health environments.
• Coordinate discharge planning, ensuring smooth transitions from hospital to home or other care facilities while optimizing post-acute recovery.
• Utilize Electronic Health Records (EHR) systems to document medical records accurately, track patient progress, and facilitate communication among care teams.
• Engage in utilization management by reviewing diagnostic evaluations and managing resources effectively to promote appropriate care levels.
• Provide patient education on health management, medication adherence, and preventive practices while maintaining HIPAA compliance for confidentiality.

Skills

• Knowledge of hospital medicine, medical-surgical units, behavioral health, geriatrics, pediatrics, and hospice care.
• Proficiency in managing electronic health records (EHR), medical terminology, and healthcare information systems.
• Excellent patient service skills with the ability to communicate effectively with clients and collaborate seamlessly with multidisciplinary teams.
• Strong understanding of physiology principles and clinical case management practices across inpatient and outpatient settings.
• Familiarity with health regulation policies such as HIPAA and managed care protocols to ensure compliance and quality standards.

Join us as a Health Home Registered Nurse Case Manager to empower patients through expert clinical guidance and compassionate support! Your dedication will help improve health outcomes while advancing your career in a vibrant healthcare environment committed to excellence.

Pay: $42.00 - $45.00 per hour

Benefits

• 401(k) matching
• Health insurance
• Paid sick time

Work Location: Hybrid remote in Lynchburg, VA 24503