RN Case Manager

Salary: $76,000 - $83,000 per year depending on experience, plus bonus potential

Location: Oak Ridge, TN

Full-Time, Monday-Friday

*Participates in on-call rotation 1 week each month

Benefits Summary

• Medical, dental, vision, and 401K
• Health Savings Account (HSA)
• Matching 401k
• Unlimited Paid Time Off (PTO)
• Mileage Reimbursement

SUMMARY 

The RN Case Manager is responsible for overseeing the delivery of coordinated care for a patient and/or an assigned group of patients. Additionally, this position is responsible for the day-to-day management and supervision of the related clinical care activities within the area the Case Manager services. 

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: Employee must have regular attendance/punctuality, be able to work with others at all levels of the Company, have exceptional customer service, and demonstrate a comprehensive in-home clinical knowledge base. Other assigned duties include:

1. Provides accurate and complete documentation with rationale to ensure reauthorization of patients.
2. Delivers services in the field or away from assigned office 50% of the time. Field activities include tasks such as in-home RN scheduled visits, attending physician appointments.
3. Assists in the implementation of the Plan of Care (‘POC’) and any amendments to the POC as needed. 
4. Conducts the orientation of new staff and coordinates them starting in patients’ homes.
5. Serves as a resource to new staff for training and follow up after training to ensure staff satisfaction and retention.
6. Submits all nursing documentation timely per company policy
7. Completes assigned chart reviews as assigned within established time frames and follows up and councils’ staff on documentation issues as necessary and ensure documentation is turned in on time.
8. Establish and promote a collaborative relationship with patient, physicians, payers, and other members of the healthcare team. 
9. Assist authorization team to collect and communicate pertinent, timely information to payers to ensure reauthorization of patient’s home health care services.
10. Actively involved in the process improvement activities to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
11. Participates in assigned quality assurance committee(s) and interdepartmental projects when needed or requested.
12. Demonstrates current knowledge of Payor policy and procedure(s).
13. Assist with state survey preparation and implementation and act as the back up administrator as assigned.
14. Other duties as assigned.

SUPERVISORY RESPONSIBILITIES

This position has direct supervisory responsibilities. This position will perform supervisory visits as needed.  

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and /or ability required.

EDUCATION and/or EXPERIENCE 

Required:

• Associate's or Bachelor’s degree in a related field
• Current Registered Nurse (RN) license to practice professional nursing in each state where patient care is supervised
• Current Basic Cardiac Life Support certification 
• At least one (1) year of staff scheduling experience 
• At least one (1) year of Case Management experience

Preferred:

• Home Health experience strongly preferred
• Department of Labor (DOL) / EEOICPA experience strongly preferred

CERTIFICATES, LICENSES, REGISTRATIONS, & MEDICAL REQUIREMENTS

• ·Valid Driver’s License
•  Active RN License 

CLEARANCES 

The following background checks are conducted:

• Criminal background 
• Driving Record 

#TFIND