Guidehealth
healthcare
RNCaseManager-Remote
Neural analysis suggests this role is
optimal for mid candidates.
“RN Case Manager - Remote at Guidehealth. Skills: RN Case Management, patient assessment, care planning, patient education, EHR documentation. 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.”
What You'll Achieve.
optimize the patient’s health status through assessment, planning, implementation, coordination, monitoring, and evaluation of the options and services available to the patient.; achieve optimal quality, clinical, and financial outcomes.; Supporting quality outcomes (HEDIS, NCQA) by coordinating preventive services and managing chronic conditions.
Industry & Context.
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
This is primarily a remote position that will require travel as needed (10%-15%) to clinical sites in the Atlanta, GA area., Protecting patient privacy in a secure, private home workspace., Observance of patient confidentiality through the use of the provided headset during all conversations in a private home office without distraction., 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., Employees must be accessible during our stated working hours., Employees are asked to join virtual meetings with their cameras on.
What They're Looking For.
Must Have
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, 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, 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, Compliance with all Guidehealth policies and procedures
Nice to Have
Bachelor of Science in Nursing, preferred, Certification in Case Management, preferred, BSN and Case Management certification preferred
What You'll Do.
Conducting in-depth telephonic assessments to understand each patient’s medical
Reviewing and updating medical histories—including medications
Developing individualized care plans and guiding patients through their treatment goals and care options.
evidence-based education on chronic disease management and preventive health.
Monitoring progress by phone
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
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
and clinical training to stay current with care standards.
Using multiple communication methods (phone
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.
How You'll Work.
Team & Collaboration
Partner with clinical teams to provide complex case management.; Collaborate with their assigned Healthguides to achieve optimal quality, clinical, and financial outcomes.; Participate in virtual meetings, engaging effectively with healthcare teams, patients, and stakeholders.; Collaborate in AI-driven outreach programs that help connect with vulnerable populations.; Support patients and the care team.
Communication Scope
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.
Process & Methodology
Ability to manage multiple priorities, meet deadlines, and work independently in a fast-paced environment, ensuring timely and efficient case management.
Full Job 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!! 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
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