RN Case Manager - Remote
hace 15 días
Douglasville
Job DescriptionCompany Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. As a growing and innovative organization, we operate with a high degree of agility. Employees are expected to adapt to evolving business needs, step in to support cross-functional initiatives, and contribute beyond traditional role boundaries when needed. This collaborative and flexible mindset is essential to our success. We encourage cross-training, ongoing development, and a commitment to learning across all areas of the business—ensuring we continue to grow and you continue to thrive as a high-performing, mission-driven team. Join us as we put healthcare on a better path!! Job Description As an RN Case Manager, you will partner with clinical teams to provide complex case management and strengthen the connection between the patient, the primary care physician/medical practice staff, and the patient’s care team. The Registered Nurse (RN) Case Manager is responsible for a specific patient population experiencing complex medical conditions, socio-economic, and/or mental health co-morbidities. The RN Case Manager will optimize the patient’s health status through assessment, planning, implementation, coordination, monitoring, and evaluation of the options and services available to the patient. The RN Case Manager collaborates with their assigned Healthguides to achieve optimal quality, clinical, and financial outcomes. This is primarily a remote position that will require travel as needed (10%-15%) to clinical sites in the Atlanta, GA area. What you'll be doing: • Conducting in-depth telephonic assessments to understand each patient’s medical, psychosocial, and social needs., • Reviewing and updating medical histories—including medications, chronic conditions, and preventive care., • Developing individualized care plans and guiding patients through their treatment goals and care options., • Providing empathetic, evidence-based education on chronic disease management and preventive health., • Monitoring progress by phone, adjusting care plans, and ensuring patients stay connected to their providers., • Completing Medicare Annual Wellness Visits (AWVs) via telehealth under physician supervision., • Partnering with Healthguides who support non-clinical needs such as scheduling, transportation, food assistance, and SDOH resources., • Performing proactive outreach and timely follow-ups to maintain continuity of care and patient engagement., • Advocating for patients, helping them access the right resources at the right time., • Documenting clearly and accurately in the EHR and care-management systems during and after calls., • Supporting quality outcomes (HEDIS, NCQA) by coordinating preventive services and managing chronic conditions., • Participating in virtual meetings, ongoing education, and clinical training to stay current with care standards., • Using multiple communication methods (phone, text, patient portals, email, AI-supported tools) to reach high-risk patients., • Collaborating in AI-driven outreach programs that help connect with vulnerable populations., • Protecting patient privacy in a secure, private home workspace., • Performing additional responsibilities as needed to support patients and the care team.Qualifications What you'll need for success: • Licensed Registered Nurse in good standing in the State of Georgia with a compact license., • 3+ years of RN Case Management experience in an outpatient setting., • Bachelor of Science in Nursing, preferred., • Certification in Case Management, preferred., • Strong problem-solving skills to diagnose, troubleshoot, and resolve barriers to patient care, workflows, and care plan progression., • Ability to analyze complex healthcare challenges and implement effective solutions while maintaining compliance within a high-regulation healthcare environment., • Ability to manage multiple priorities, meet deadlines, and work independently in a fast-paced environment, ensuring timely and efficient case management., • Exceptional written, visual, and verbal communication skills., • Ability to participate in virtual meetings with clear verbal communication, engaging effectively with healthcare teams, patients, and stakeholders., • Exceptional conversational skills and the ability to precisely document patient interviews, leveraging software in real time., • Strong interpersonal skills with a focus on empathy, patience, professionalism, and respect in all patient, team, and client interactions., • Demonstrated competency and ability to independently navigate technology using multiple platforms, computer screens, and other technical components (i.e., Electronic Medical Records, care management analytics databases, phone dialing system, Microsoft Office)., • Ability to meet accreditation and quality standards, including but not limited to NCQA and HEDIS., • Observance of patient confidentiality through the use of the provided headset during all conversations in a private home office without distraction., • BSN and Case Management certification preferred. Additional Information The salary range for this role is $80,000.00 to $83,000.00 ALIVE with Purpose: How We Thrive at Guidehealth At Guidehealth, our values come to life in everything we do. • We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike., • Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare., • With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve., • At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member., • And through Empathy in Action, we build stronger connections with those who count on us. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include: • Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs., • Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered., • Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution., • Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected., • Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times., • Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals., • Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need. COMPENSATION: The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications. OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment. OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager. As a remote-first organization handling sensitive healthcare data, Guidehealth verifies candidate identity at multiple stages of the hiring and onboarding to safeguard patient privacy, data security, and compliance requirements. REMOTE WORK TECHNICAL REQUIREMENTS Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements. SECONDARY EMPLOYMENT At Guidehealth, we value transparency and collaboration as part of our commitment to excellence. As your primary employer, we kindly ask all team members to disclose any secondary employment, regardless of whether it may present a potential conflict of interest. To ensure smooth teamwork and availability, employees must be accessible during our stated working hours. We foster connection and engagement by asking team members to join virtual meetings with their cameras on.
