• RN Case Manager - Skilled Nursing

    PruittHealth (Norcross, GA)


    POSITION 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 required

    **Family Makes Us Stronger.** Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.

     

    We are eager to connect with you! **_Apply Now_** to get started at PruittHealth!

     

    _As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status._