PruittHealth RN Case Manager in Norcross, Georgia
Category : Commercial Care Mgmt
Location/City : GA - Norcross
Id : 23918
Title: Case Manager - RNLocation: Norcross, GAPOSITION SUMMARY:Ensures the continuation of medically necessary services to our patients post -acute care. Demonstrates understanding of post-acute services and case management as it relates to the continuum of care.ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES: Demonstrates the ability to understand CMS and Commercial Insurance requirements to ensure compliance with regulations and standards. Must be knowledgeable of medical necessity review guidelines for commercial, Medicare, and Medicaid insurance products. Uses knowledge of insurance criteria and regulations in order to expedite appropriate use of resources and compliance with third party payer contracts. Demonstrates the ability to communicate effectively via phone and email with our internal and external customers. Strong organization and ability to multi task is essential to success in this role.LICENSURE, CERTIFICATION, EXPERIENCE AND EDUCATION REQUIREMENTS: BSN preferred Currently licensed Registered Nurse in the state of GA. A minimum of 3-years of clinical experience is required. Home Health Care and or skilled nursing industry experience highly preferred. RN Case Management experience preferred. Must be proficient in the use of computer applications for daily use. Highly proficient in Microsoft Word, Intermediate Excel and Outlook requiredWe offer a progressive benefits program that reflects our commitment to caring for our 16,000 partners:* 5-Star bonus incentive programs for achieving quality goals* Partner Referral Program â Earn cash for referring licensed and certified candidates* Employer paid profit sharing* Employer matching 401(k)* Paid Time Off (PTO) accruals beginning the first day of employment* Access to "Purchasing Power" financial health program after one year of employmentFor immediate consideration, please click the "Apply Now" at the top right of this screen.At PruittHealth, Committed to Caring isn't simply a tagline, it's the way we do business and it's ingrained in our culture. At PruittHealth, we don't hire employees â we welcome partners!Since its inception in 1969, PruittHealth has been a family-owned innovative organization committed to providing exceptional care across a wide spectrum of services including: skilled nursing care, assisted & independent living, home health care, end-of-life hospice care, rehabilitation, pharmacy/infusion services and more.
Today, the organization is the 14th largest skilled nursing provider in the United States, spans across the Southeast, touches 170 communities, cares for 24,000 patients daily, and is driven by 16,000 passionate partners.PruittHealth is an Equal Employment Opportunity employer and all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability or veteran status.