Works with physicians and team members to develop and monitor patient care plans, ensuring progression towards desired outcomes and identifying barriers.
Reviews reservation forms and logs for urgent admissions, assessing appropriate levels of care and working with physicians on pre-certification discrepancies.
Oversees inpatient denials, collaborating with the Medical Director on appeal decisions, and benchmarks with other facilities on admission policies and denial experiences.
Dartmouth Health is a nationally recognized Academic Medical Center system spanning New Hampshire and Vermont. It includes the Dartmouth Hitchcock Medical Center, an NCI-designated cancer center, children's hospital, member hospitals, and ambulatory clinics, with a rigorous, research-focused environment and a shared governance nursing model.
Provide virtual clinical assessments and care for Medicare patients with complex, chronic needs across multiple states.
Partner with RNs and clinical leadership to develop care plans, manage chronic conditions, and support escalations via telemedicine.
Collaborate with operations and product teams to improve care workflows and maintain accurate, compliant clinical documentation.
Pair Team is a tech-enabled medical group reimagining care delivery for Medicaid and Medicare's most underserved populations by providing whole-person clinical, behavioral, and social support. The collaborative team includes nurses, social workers, and medical professionals, and the company is one of California's largest care management providers with a demonstrated impact on reducing hospital visits.
The RN Case Manager serves as a trusted clinical partner to patients, families, providers, and interdisciplinary teams, guiding individuals through complex health journeys with compassion, clinical excellence, and purpose.
The RN Case Manager is responsible for assessment, care planning, coordination, monitoring, and evaluation of services for a defined population, including members with chronic, complex, and high-risk conditions.
Working closely with primary care providers, patient navigators, and other care team members, the Care Manager – Registered Nurse ensures safe, effective, equitable, and patient-centered care within a value-based care model.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. They aim to make healthcare affordable, improve patient health, and restore fulfillment in practicing medicine for providers. This growing organization operates with agility, encouraging cross-training, development, and learning across all areas of the business.