Care Manager RN

About Us

Caring for Atlanta for over 78 years, Visiting Nurse Health System is a leading, non-profit provider of home healthcare, long-term care at home, hospice, and palliative care services. We pride ourselves in helping patients and their loved ones receive care at home following an illness, surgery, or hospital stay. Our vision is to be the first choice for patients, families, payers, and other healthcare providers when they need home healthcare services. We aim to maintain exemplary patient and employee satisfaction levels through strong community partnerships, coordinated care solutions, a top-performing workforce, and innovative technologies.

We strive to display our four core values:

• Respect & Integrity: We practice the highest ethical standards and honor our commitments. We value the beliefs and opinions of our diverse community of patients and employees.
• Excellence: We are committed to delivering the best outcomes and highest quality service through the dedicated efforts of every team member.
• Stewardship: We enhance the lives of those we serve through responsible planning and management of resources.
• Care: We provide compassionate person-centered care while respecting individual physical, emotional, and spiritual needs.

About the Role

The Care Manager RN plays a key role in assessing, coordinating, and monitoring community-based services for elderly or disabled clients under the Community Care Services Program (CCSP). This role includes conducting home visits, reassessing care needs, developing plans of care, and collaborating with physicians, social workers, and caregivers to ensure continuity of care.

Responsibilities

• Conduct in-home or facility-based assessments of clients to determine appropriate services.
• Collaborate with SW Care Managers and interdisciplinary teams on level-of-care (LOC) decisions.
• Develop care paths and discharge plans based on client needs, condition, and support systems.
• Complete and document assessment tools (e.g., GDS, MMSE, fall risk).
• Schedule and perform timely assessments, reassessments, and follow-up per DCH policy.
• Coordinate transitions from hospital to home/community settings.
• Document care plans, hospitalizations, care transitions, services, and case notes per DCH and VNHS standards.
• Approve services within established funding limits and ensure clinical appropriateness.
• Participate in interdisciplinary team meetings, training sessions, and quarterly network events.
• Support infection control practices and maintain confidential client records.

Requirements

• Graduate of an accredited RN program.
• Current Georgia licensure and CPR certification.
• 2 years of nursing experience in community health, long-term care, or geriatrics.
• Understanding of Medicare/Medicaid regulations and care coordination best practices.
• Ability to function independently in a community-based environment.
• Strong clinical, documentation, and time management skills.
• Comfortable with EMR systems and standard office software.
• Reliable transportation and comfort traveling to client homes.

Benefits

• Medical, Dental, and Vision insurance.
• PTO and Paid Holidays.
• 403b Retirement Plan with Company Match.
• Flexible Spending Account (FSA).
• Health Savings Account (HSA).
• Life Insurance.
• Employee Assistance Program.
• Employee Discounts.
• Flexible Schedule.

Pay

Pay Per Visit

Schedule

PRN

Location

Hall, Barrow, Forsyth, North Gwinnett