About this opportunity
Pruitthealth Corporation lists this RN Case Manager opportunity in norcross, Georgia. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Job Description - RN Case Manager )
RN Case Manager -
Description
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
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.
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! 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.
For Florida Job Postings Only
For more information regarding Florida’s Care Provider Background Screening Clearinghouse Education and Awareness, please visit
#J-18808-Ljbffr
Worksite address
norcross, GA, 30092, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.