Case Manager

Job Title: Care Manager | Case Manager

Work Hours: Monday – Friday, 8:00 AM – 5:00 PM

License/Certification Required: Registered Nurse (RN) License and BLS Certification

Preferred Certification: IV Certified

Position Overview:

The Care Manager (CM) plays a vital role in improving patient outcomes by reducing hospital admissions, readmissions, and emergency room visits. This position supports high-risk patients in navigating the healthcare system, empowering them through education, advocacy, and resource coordination. The CM collaborates with a multidisciplinary care team to ensure continuity and quality of care.

Team Structure:

You will work alongside:

·1 Medical Doctor (MD)

·1 Advanced Practice Registered Nurse (APRN)

·2 Medical Assistants (MAs)

·2 Front Desk Staff

·1 Care Coordinator

·1 Care Manager (peer)

The team culture is collaborative, patient-centered, and focused on proactive care delivery.

Key Responsibilities:

·Prioritize patient care needs during initial visits and address emerging issues.

·Meet with patients, families, and caregivers to discuss care and treatment plans.

·Identify and follow up with high-risk patients across various care settings (acute, SNF, custodial, ambulatory).

·Apply evidence-based protocols and care pathways to optimize clinical outcomes.

·Coordinate discharge planning, including follow-up appointments, home health, transportation, and social services.

·Maintain effective communication with physicians, hospitalists, and other care team members.

·Use data and reporting tools to understand the cost implications of care management decisions.

·Participate in daily huddles and Patient Care Coordination (PCC) meetings.

·Prepare and present accurate reports for weekly team meetings.

Required Skills & Experience:

·Minimum of 2–3 years of experience in a hospital, urgent care, or primary care setting.

·Strong verbal and written communication skills.

·Ability to work independently and manage multiple priorities in a fast-paced environment.

·Proficiency in Microsoft Office and Excel.

·Working knowledge of medical terminology and HIPAA regulations.

·Ability to interact professionally with patients and healthcare personnel.

·Must be able to pass a color blindness test.

Preferred Background:

·Experience with Medicare Advantage Care.

·IV certification is a plus.

Pride Global offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.