administrative assistant

senior executive assistant Jobs in Atlanta

senior executive assistant

case manager, employment services Jobs in Atlanta

case manager, employment services

community support coordinator Jobs in Atlanta

community support coordinator

hr services - benefits specialist Jobs in Atlanta

hr services - benefits specialist

case manager employment services

U.S. Committee for Refugees and Immigrants

<div><div><p><b>U.S. Committee for Refugees and Immigrants</b> (USCRI), is a non-governmental, not-for-profit international organization with a mission to protect the rights and address the needs of persons in migration by advancing fair and humane public policy, facilitating, and providing direct professional services, and promoting the full participation of migrants in community life. For over 100 years, we have shaped history with the belief that immigrants strengthen our communities, economy and social fabric through freedom, hard work, and family unity. To learn more about our work, please go to our official website at www.refugees.org.</p><p>
OVERVIEW</p><p>
The Case Manager of Employment Services will oversee State and Federally funded employment programs, as well as perform employment-related activities, to help refugee clients find jobs and work towards the goal of self-sufficiency.</p><p>
ESSENTIAL DUTIES AND RESPONSIBILITIES</p><ul><li>
Understands State and Federal program contracts in detail, ensures all contract requirements are met and opportunities maximized;</li><li>
Teach small groups of clients&rsquo; basic workplace overview job preparation, interview skills and job safety requirements to enable them to be successful in the American workplace;</li><li>
Foster strong working relationships with businesses, community-based organizations, and partner agencies; provides consistent communication with partner agencies to ensure coordination of services and development of job placement opportunities;</li><li>
Work with targeted businesses and industries to develop potential worksites and employment opportunities for clients, negotiates worksite training agreements or special accommodations, monitors and tracks success following placement, serves as primary contact person and maintains database of current and potential business partners;</li><li>
Assess experience, skills and limitations of clients; identifies job opportunities suitable for clients; assists clients in filling out employment applications, sets up interviews with potential employers, accompanies clients to interviews or arranges transportation; and</li><li>
Perform other duties as assigned by supervisor.</li></ul><p>
All of the above duties and responsibilities are essential job functions subject to reasonable accommodation. All job duties indicated is not to be an exhaustive statement and other job-related duties may be assigned as required by the supervisor(s).</p><p>
POSITION REQUIREMENTS</p><ul><li>
Bachelor&rsquo;s degree from and accredited institution, preferable in Human Services, Social Work or related discipline;</li><li>
Excellent interpersonal skills, including the ability to communicate well, building relationship and partnership with USCRI clients, employment partners, state and federal program staff, headquarters and field office staff;</li><li>
Proficient in the use of MS Word, MS Excel and database programs, as needed;</li><li>
Good Sense of humor and pleasant, diplomatic manner with the ability to get along with others and thrive in a team environment;</li><li>
Demonstrated commitment to the mission of USCRI, and interest in contributing to the long-term success of a local nonprofit organization;</li><li>
Must have a clean valid driver&rsquo;s license and insurance, and a reliable motor vehicle; and</li><li>
Demonstrated support of USCRI&rsquo;s values by exhibiting respect for others, maintenance of confidential information and an appreciation of a multicultural workplace.</li></ul><p><b>
TRAINING REQUIREMENT</b></p><ul><li>
Satisfactory completion of USCRI&rsquo;s Orientation and Training; and</li><li>
Complete additional training as identified by supervisor or Human Resources.</li></ul><p><b>
PHYSICAL DEMANDS</b></p><ul><li>
Use of manual dexterity, tactile, visual, and audio acuity;</li><li>
Use of repetitive motion, prolonged periods of sitting and standing, and sustained visual and mental applications and demands;</li><li>
Occasional lifting (up to 25 pounds), bending, pulling, and carrying; and</li><li>
Quantitative/mathematical ability (addition, subtraction, multiplication, division, standard measurements.</li></ul><p>
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p><b>
EQUAL EMPLOYMENT OPPORTUNITY</b></p><p>
U.S. Committee for Refugees and Immigrants is an equal opportunity employer. We maintain a policy of equal employment opportunity without regard to race, color, national origin, ancestry, religion, sex, sexual orientation, gender identity, domestic partnership status, marital status, physical or mental disability, AIDS/HIV status, age, political affiliation, genetic information, veteran status or any other characteristic protected by applicable law.</p></div></div>

Case Manager, Employment Services

AIDS Healthcare Foundation

<div>Overview:
<p><b>
Join the Team &ndash; Make A Difference! Work at AID Atlanta, an affiliate of AHF.</b></p><p></p><p><br>
AID Atlanta, Inc. has been saving and transforming lives since its inception in 1982. The agency is the Southeast&rsquo;s oldest, largest, and most comprehensive AIDS Service Organization.</p><p>
Today, AID Atlanta offers a broad range of services and has grown to be the most comprehensive AIDS service organization in the Southeast. AID Atlanta currently offers HIV/AIDS prevention and care services, including (but not limited to) Primary Care, HIV/STD Screening, PrEP, Community HIV Prevention Programs, Linkage Services, Case Management, and a state-wide Information Hotline.</p><p>
The mission of AID Atlanta is to reduce new HIV infections and improve the quality of life of its clients by breaking barriers and building community.</p><p>
AID Atlanta&rsquo;s core values:</p><ul><li>
Respect</li><li>
Compassion</li><li>
Service</li><li>
Integrity</li></ul><p><b>
If you would like to be a part of fostering empowerment in someone&rsquo;s life, AID Atlanta is the place for you.</b></p>
Responsibilities:
<p><b>
Required:</b></p><div><b>
Bachelor&rsquo;s Degree in Human Services, Psychology, Sociology or Social Work related field and 1-2 years&rsquo; experience in the field of social work/case management or similar field.</b></div><div></div><div><br>
JOB SUMMARY</div><div></div><div><br>
The Medical Case Manager (MCM) works with members to remove barriers to HIV/AIDS medical care by facilitating a collaborative process that identifies members&rsquo; needs, a plan to address those needs, and continuous follow-up to ensure that members obtain the necessary services that help them to maintain adherence and retention to medical care. The MCM also coordinates with other service providers through a comprehensive and active referral process to link HIV+ individuals into appropriate services and care.</div><div></div><div><br>
ESSENTIAL DUTIES &amp; RESPONSIBILITIES</div><div>
o Provide direct service coordination and support to people living with HIV/AIDS</div><div>
o Provide Case Management services to members on a walk-in, scheduled, and on-call basis.</div><div>
o Manage a caseload of up to 50 members</div><div>
o Conduct initial comprehensive assessment and intake for eligible members</div><div>
o Collaboratively develop and implement Individualized Service Plan (ISP) for each member on caseload, including conducting ISP updates every 6 months for each member.</div><div>
o Assess and evaluate member&rsquo;s initial needs through the EMA screening tool.</div><div>
o Educate members about Case Management, and policies (Grievance, HIPPA, Member&rsquo;s Rights and Responsibilities) and other agency program policies to ensure member has clear expectations of services.</div><div>
o Provide regular monthly (or more) contact with members to follow up on treatment plan goals and provide intervention as needed.</div><div>
o Advocate and mediate on member&rsquo;s behalf to decrease or eliminate barriers to care.</div><div>
o Educate members about the importance of participating in medical care and ensure that members have full access to primary medical care and medication.</div><div>
o Assess and Educate members about the importance of medication and medical adherence to improve member&rsquo;s clinical outcomes.</div><div>
o Assess and educate members about harm reduction, prevention, and other HIV-related sexual transmitted infections (STIs).</div><div>
o Conduct home and hospital visits, accompanying members to appointments as needed.</div><div>
o Organize and facilitate new member orientation to ensure members have a clear understanding of how Case Management can be utilized beneficially.</div><div>
o Assess, verify and maintain records of a member&rsquo;s eligibility for Case Management and various entitlement programs.</div><div>
o Document all encounters with or on behalf of a member within 72 hours in the Electronic Medical Records (EMR) system.</div><div>
o Assess, collect, and maintain accurate member information and records in a confidential manner.</div><div>
o Complete monthly reporting to ensure accurate programmatic reporting (based on position/site assigned)</div><div>
o Provide active referrals and application assistance and support to members.</div><div>
o Educate members about various community resources and programs to increase their knowledge of appropriate referrals.</div><div>
o Collaborate with physicians, nurses, and other clinical staff in the development and execution of member&rsquo;s plan of care.</div><div>
o Attend monthly interdisciplinary meetings with medical providers (based on-site).</div><div>
o Maintain up-to-date resources of community services.</div><div>
o Participate in and volunteer for intra and interdepartmental activities/events across the agency (i.e. AIDS Walk fundraising, agency sponsored events, member centered events, etc).</div><div>
o Communicate regularly with manager about changes, updates, and/or improvement suggestions in service delivery issues or other agency-related issues that directly or indirectly impact staff and/or members.</div><div>
o Attend agency, local, state, and national meetings, conferences, or workshops as needed or required.</div><div>
o Adhere to policies and procedures for AID Atlanta and other off-site programs to ensure quality standards are met.</div><div>
o Abide by NASW code of ethics, HIPPA and Atlanta EMA Case Management Standards to ensure a high level of professionalism is maintained.</div><div>
o Address members concerns utilizing the Customer Service Standards.</div><div>
o Perform routine self audits and maintain charts to ensure members information and eligibility documents are current.</div><div>
o Meet with supervisor at least on a monthly basis to staff member cases, discuss chart audits/observation results, and to discuss performance and progress of stated goals.</div><div>
o Attend all required internal and external (for off-sites) meetings.</div><div>
o Participate in various mandatory trainings held internally and externally ensuring a continuous knowledge base of programs that benefit members.
</div><div>o Be a participant in the hiring and training of new case managers as requested by manager.</div><div></div><div><br>
SUPERVISORY RESPONSIBILITIES :</div><div>
None</div><div></div><div><br>
QUALIFICATIONS: EDUCATION &amp; WORK EXPERIENCE</div><div>
o Bachelor&rsquo;s Degree in Social Work, Psychology, Sociology, Human Services or social services-related field.</div><div>
o 1-2 years experience in the field of social work/case management or similar field.<br>
o Experience in the field of HIV is preferred, but not required</div><div>
o Must pass criminal background check.</div><br>
<div></div>
Qualifications:
<div><i>
We at AID Atlanta/AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability. The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment. AHF will consider qualified applicants with criminal histories in a manner consistent with the requirements of the ordinance.</i></div></div>

Medical Case Manager

River Edge Behavioral Health Center

<div><div><i>About River Edge Behavioral Health</i><br>
</div><div>
Serving more than 10,000 Georgians, River Edge continues to be one of the state's leading resources for mental health, substance use disorder treatments and supports as well as individuals with intellectual and development disabilities. River Edge offers outpatient services at our Emery Highway-Macon, Monroe County and Baldwin County locations. Outpatient services include behavioral health, nursing, and psychiatric assessment, stabilization and medication maintenance services as well as crisis intervention services as well as awareness, education and recovery groups.<br>
</div><div>
River Edge is seeking a motivated and organized individual to join our team as a Team Lead for Case Management within the Permanent Supportive Housing program. Under the supervision of the Program Manager, the Team Lead will support day-to-day operations of the case management team, ensuring effective service delivery, housing stability, and successful program outcomes for individuals and families transitioning from homelessness.</div><div><b>
</b></div><div><b>
Schedule: </b>Monday to Friday: 8:00 AM &ndash; 5:00 PM<br>
</div><div><b>
Duties and Responsibilities:</b></div><ul><li>
Provide oversight and daily support to a team of Case Managers and Peer Specialists to ensure consistent service delivery.</li><li>
Assist with coordinating housing placements, move-ins, and unit readiness (including furniture, supplies, and welcome kits).</li><li>
Monitor team productivity, caseloads, and documentation to ensure timely and accurate completion of required tasks.</li><li>
Serve as a point of contact for housing updates, unit availability, and coordinated entry system (CES) communication.</li><li>
Support staff in addressing participant needs related to housing stability, including move-ins, transfers, and retention.</li><li>
Coordinate and track housing-related supplies, inventory, and distribution for new move-ins.</li><li>
Maintain organized program data including housing status, move-in timelines, and participant outcomes.</li><li>
Assist with preparing monthly and quarterly program reports for leadership and funding partners.</li><li>
Collaborate with community partners including housing authorities, property managers, and local service providers.</li><li>
Support onboarding and training of new case management staff on workflows, expectations, and program processes.</li><li>
Identify workflow gaps and recommend improvements to increase efficiency and team performance.</li><li>
Ensure staff are following program guidelines, timelines, and housing-focused service expectations.</li><li>
Conduct regular team check-ins and assist with problem-solving barriers to housing placement and retention.</li><li>
Participate in meetings with leadership and external partners as needed.</li></ul><div>
</div><div><b>
Qualifications</b></div><ul><li>
Bachelor&rsquo;s degree in human services, Social Services, Public Administration, or related field. Masters level preferred.</li><li>
Minimum of 2&ndash;3 years&rsquo; experience in case management, housing programs, or supportive services.</li><li>
Experience working with individuals experiencing homelessness or housing instability preferred.</li><li>
Strong organizational, leadership, and communication skills.</li><li>
Ability to manage multiple priorities and support a team in a fast-paced environment.</li><li>
Knowledge of community resources, housing systems, or coordinated entry systems is a plus.</li><li>
Proficient in documentation, data tracking, and basic reporting.</li><li>
All applicants must pass an intensive background check and pre-employment drug test.</li></ul><div></div><div><b><br>
Additional Benefits:</b></div><ul><li>
Flexible spending accounts</li><li>
Short and long-term disability coverage</li><li>
11 Paid holidays</li><li>
Voluntary Life Insurance.</li></ul><div></div><div><br>
If you are looking for an opportunity to make life better and a strong desire for personal growth we encourage you to apply. We promptly review all applications. Highly qualified candidates will be contacted for interviews.<br>
</div><div>
We are an equal opportunity employer and highly value diversity. We do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.<br>
</div><div><b>
All selected applicants must pass a satisfactory background clearance and pre-employment drug test.</b></div></div>

Team Lead Case Management Permanent Supportive Housing

Quality Life Management, LLC

<p><b>Company Description</b></p><p>Quality Life Management is a compassionate care agency dedicated to improving the lives of individuals with disabilities through personalized support and comprehensive case management. We focus on empowering our clients to live fulfilling, independent lives by connecting them with the right resources, services, and community programs. Our team is committed to excellence, empathy, and creating a positive impact in every life we touch.</p><p><b>Role Description</b></p><p>This is a flexible role for a Case Manager, <b>located in Georgia, with requirements to travel within west, north, and east GA</b>. The Case Manager will be responsible for assessing, planning, and implementing care plans for clients. Day-to-day tasks include liaising with clients and their families, coordinating with service providers, monitoring client progress, maintaining detailed records, and ensuring that clients receive the necessary services to meet their individual needs. The Case Manager will work closely with other team members to enhance client outcomes and ensure continuity of care.</p><p><b>Qualifications</b></p><ul><li><b>Experience in Monitoring Client Progress and Maintaining DETAILED Records</b></li><li>Assessment, Planning, and Implementation skills</li><li>Client Liaison and Coordination skills</li><li><b>RELIABLE TRANSPORTATION</b></li><li>Excellent Communication and Interpersonal skills</li><li><b>Ability to work flexibly in west, east, north, and Georgia</b></li><li><b>Bachelor's degree</b> in Social Work, Psychology, Counseling, or related field</li><li>Experience working with diverse populations is a plus</li><li>Problem-solving and Decision-making skills</li></ul><p><b>Requirements</b></p><ul><li>Proven experience in case management within behavioral health or social work settings</li><li>Strong knowledge of crisis management protocols and behavioral health practices</li><li>Skilled in motivational interviewing techniques to motivate change and build rapport with diverse populations</li><li>Excellent communication skills&mdash;empathetic listening and clear documentation are essential</li><li>Ability to handle sensitive situations with professionalism and compassion under pressure</li><li>Relevant certifications or training in social work, behavioral health, addiction counseling or related fields are highly preferred</li></ul><p>We&rsquo;re committed to supporting your growth through ongoing training opportunities and a collaborative work environment that values your passion for making a difference.</p><p>Job Types: Part-time, Contract</p><p>Pay: $15.00 - $25.11 per hour</p><p>Expected hours: 5.0 &ndash; 20.0 per week</p><p>Benefits:</p><ul><li>Flexible schedule</li></ul><p>Work Location: Hybrid remote in Atlanta, GA 30310</p>

CASE MANAGER - North & East Georgia!!

The Legacy Link, Inc.

<p><b>Senior Community Service &amp; Employment Program (SCSEP) Participant Specialist</b></p><p><b>(Senior Employment Case Manager)</b></p><p><b>DEPARTMENT:</b> SCSEP</p><p><b>ACCOUNTABILITY:</b> Reports to the Assistant Director <b>STATUS:</b> Full-Time, Exempt</p><p><b>ANNUAL SALARY</b>: $49,172.90 (D2 Scale)</p><p><b>JOB SUMMARY</b>: Manages all phases of the Senior Community Services Employment Program for assigned region, including enrollments, transfers, placements, host agency recruitment/training, IEPs, and case management.</p><p><b>Atlanta Office Summary:</b></p><p>We are hiring a Participant Specialist based in the Atlanta Legacy Link office located inside the Clayton County DOL. This person oversees approximately 14 counties with approximately 100 trainees on the case load. The Participant Specialist has direct reports, Participant Assistants, who report in-person to the office.</p><p>A Participant Specialist is a traveling senior employment caseworker whose primary duty is to drive to the county of the interested applicant to conduct an in-person application, enabling the applicant to join our senior job training program. A secondary duty involves recruiting non-profit and government agencies to host our job training seniors. Both activities require travel, typically 2 days per week using your personal vehicle. Mileage is reimbursed based on the IRS Standard Mileage rate.</p><p>When not traveling, the Participant Specialist works out of the Atlanta office. The role is fast-paced and involves managing multiple competing priorities simultaneously. Working hours are Monday to Friday, from 8:00 AM to 4:30 PM. The ultimate goal of the program is to make seniors employable through paid job training opportunities at nonprofit or government agencies.</p><p><b>This position REQUIRES travel to regional counties at least 2 times per week in your personal vehicle with mileage reimbursement based on the IRS Standard Mileage rate.</b> <b>Overnight travel is required, usually twice per year for statewide meetings. </b></p><p><b>Essential Functions:</b></p><p>&middot; Recruit, enroll, and manage local senior trainees (SCSEP participants)</p><p>&middot; Develop and manage community partnerships, primarily host agencies</p><p>&middot; Travel at least twice per week to conduct enrollments in regional areas (spanning ~21 counties)</p><p>&middot; Ensure performance goals and compliance measures are met by submitting accurate and timely paperwork</p><p>&middot; Recruit, train, and provide ongoing mentorship to Participant Assistants in the assigned office</p><p>&middot; Participate as a board member for workforce partners across the region</p><p>&middot; Assist with community outreach and education efforts to grow SCSEP, including presentations</p><p>&middot; Assist with payroll functions for assigned participants</p><p>&middot; Travel frequently to regional sites with the possibility of overnight stays</p><p><b>Additional Areas of Responsibility:</b></p><p>&middot; Marketing and recruitment for SCSEP</p><p>&middot; HIPAA compliance</p><p><b>Education:</b></p><p>Required: High School Diploma and nonprofit, case management, or transferable experience</p><p>Preferred: Four-year degree in social service area</p><p><b>Required: Valid Georgia Driver's License and Reliable Vehicle </b></p><p><b>Skills and Experience:</b></p><p>1. Knowledge of employment services and supportive services in the region</p><p>2. Ability to communicate the goals and objectives of SCSEP to older adults (of various education levels), training site staff, and potential employers</p><p>3. Well-organized and detail-oriented</p><p>4. Proficient computer skills with emphasis on accuracy of data captured</p><p>5. Problem-solving skills</p><p>6. Ability to follow instructions (frequently coming by email)</p><p><b>Benefits:</b></p><p>401(k) and 401(k) matching</p><p>Dental, Health, Life, and Vision insurance</p><p>Paid time off</p><p>Employee assistance program</p><p><b>Physical Demands:</b></p><p>The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of the job, on a case-by case basis.</p><p>1. Local and regional travel required two times per week with some overnight stays</p><p>2. Required to inspect and safely operate a motor vehicle in a wide range of weather and traffic conditions</p><p>3. Regularly required to use hands to write, use a computer, operate a motor vehicle, use a hand-held device and telephone, and manipulate documents</p><p>4. Regularly required to read documents and write neatly, legibly, and transcribe accurate information and numbers/values</p><p>5. Employee continually engages in activities that require talking and hearing</p><p>6. Frequent: Standing, sitting, walking, repetitive use of hands, simple grasping and fine hand manipulation, pushing and pulling with hand(s). Occasionally required to reach above shoulder level</p><p>7. Must be able to lift and/or move up to 11 pounds, and occasionally 25 pounds (When lifting more than 25 pounds, two or more people are required to lift the load.)</p><p><b>Work Environment:</b></p><p>The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job, on a case-by-case basis.</p><p>1. Temperature ranges from normal indoor climate-controlled environment in buildings or vehicles, various outdoor conditions and temperature extreme encountered during travel, and unpredictable indoor environmental conditions encountered in off-site locations.</p><p>2. Regularly exposed to outside weather conditions when traveling.</p><p>3. May be subjected to clients with communicable diseases, or may be exposed to potentially infectious materials or other conditions at job sites or other locations, which may include (but are not limited to) poor air quality, mold, mildew, fungus, exposure to cigarette smoke, etc.</p><p>4. May be required to walk on uneven terrain.</p><p>5. May be required to travel to community areas that are potentially dangerous, or to isolated rural locations.</p><p>This job description in no way states or implies that these are the only duties to be performed by this employee. He or she will be required to follow any other instructions and to perform any other duties requested by his or her supervisor.</p><p>The Legacy Link, Inc. is an Affirmative Action/Equal Opportunity Employer.</p><p>Pay: $49,172.90 per year</p><p>Benefits:</p><ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee assistance program</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Mileage reimbursement</li><li>Paid time off</li><li>Vision insurance</li></ul><p>Application Question(s):</p><ul><li>This role covers multiple counties and requires travel at least twice per week. Do you have reliable transportation and a willingness to travel?</li><li>Are you proficient with computers, including Microsoft Office, Adobe, and online data‑entry platforms?</li><li>Are you comfortable cold‑calling nonprofits and government agencies to establish partnerships?</li><li>Are you comfortable giving presentations to community partners about the SCSEP program?</li></ul><p>Ability to Commute:</p><ul><li>Atlanta, GA 30349 (Preferred)</li></ul><p>Work Location: Hybrid remote in Atlanta, GA 30349</p>

Participant Specialist (Employment Case Management)

Kaiser Permanente

<div><div><b>Job Summary:</b></div><br>
<br>
<p>Responsible for carrying out medical necessity reviews on all designated referrals for Home Care, DME Specialty Care services. The activities will include telephonic review for medical necessity of the designated services using established criteria and guidelines for coordination of services. Eligibility and benefit reviews will be performed as necessary. Identification of patients for case management, quality improvement reviews, and communication with inpatient care coordinators, case managers, providers, Customer Service, Claims, Contracts and Benefits - Appeals, Risk Management are responsibilities of the position.</p><div><b><br>
Essential Responsibilities:</b></div><br>
<br>
<ul><li>Responsible for the day to day review activities as outlined above. Utilizes established criteria to perform medical necessity review for all members requiring home health and DME services. All referral reviews will be performed within the required timeframe and with adherence to the decision notification process. Refers all cases that do not meet established criteria to the appropriate review physician. Performs benefit and eligibility reviews on referrals. Provides investigation and preparation of cases requiring review of the Chief of QRM according to the established guidelines. Understands the Complex Case Management Program and referral process; Refers patients to the Complex Case Managers according to procedure. Provides correspondence in accordance to policy and procedure for members with respect to service requests. Interacts with vendors to ensure that resources are being utilized appropriately while maintaining quality outcomes.<ul><li>
Establishes and maintains contact with case manager regarding requests and review status as appropriate.</li><li>
Refers the patient to the social workers as appropriate. Performs quality of care and service reviews using identified quality indicators. Reviews the utilization reports with the Supervisor to assure appropriateness of reviews and makes adjustments based on findings. Remains knowledgeable of contract benefits and current, relevant state and Federal regulations, criteria, documentation requirements and laws that affect managed care and case/utilization management. Maintains effective interaction/communication with members of the medical staff, health care teams, intake coordinators, complex case managers, social workers, inpatient care coordinators, referral coordinators, Member Services, Claims, Contracts and Benefits-Appeals, Risk Management and Kaiser Permanente medical offices to facilitate the review process. Builds effective working relationships with other department. Under the guidance of the supervisor, participates in the maintenance of all QRM policies and procedures related to the Transitional Care Review Program. Participates in call rotation to support after hours and weekend requests for quality resource management services.Refers cases identified as risk management, peer review or quality issues to QAIR and Risk Management.</li><li>
Document Review Activities according to documentation guidelines. Issue letters of non - coverage to members not meeting established medical necessity criteria. Works cross-functionally with other departments in striving to meet organizational goals and objectives. Achieves and maintains an understanding of relevant state and federal regulations, criteria, and documentation requirements and laws that affect managed care, home health and case/utilization management. Knowledgeable and compliant with regional personnel policies and procedures. Knowledgeable and compliant with QRM departmental and unit specific policies and procedures. Participates in annual regional and departmental compliance training. Knowledgeable and compliant with Principles of Responsibility. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.</li><li>
Responsible for assisting the Medical Office Administration, Customer Services and Provider Relations in investigating concerns and issues. Access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform the job. Demonstrates understanding of HIPAA privacy regulations by maintaining confidentiality of Protected Health Information (PHI). Demonstrates doing the right thing and doing things the right way is an underlying premise in all work related activities and is able to identify location of copy of Principles of Responsibility. Develops and maintains an awareness of how to report compliance issues and concerns. Identifies issues of wrong doing and promptly investigates and reports to immediate supervisor or Director of Regional Compliance. Assures an atmosphere and culture for staff to report issues of wrong doing. Other duties as assigned.</li></ul></li></ul><div><br>
<b>Basic Qualifications:</b></div>
<div>Experience</div><br>
<br>
<ul><li>Minimum three (3) years of clinical nursing OR completed Kaiser Permanente Nurse Residency Program in KP Georgia.</li></ul><div>
Education</div><br>
<br>
<ul><li>B.S. in Nursing or four (4) years of directly related experience.</li><li>
High school diploma or GED required.</li></ul><div>
License, Certification, Registration</div>
<ul><li>Registered Professional Nurse License (Georgia)<br>
</li></ul><div>
<b>Additional Requirements:</b></div><br>
<ul><li>
Working knowledge of all relevant federal, state, local and regulatory requirements, including Medicare.</li><li>
Functional knowledge of computers.</li><li>
Experience in ICD9/CPT4 coding.</li><li>
Experience in home health and durable medical equipment coordination.</li><li>
Experience with managed health care delivery systems.</li></ul><div>
<b>Preferred Qualifications:</b></div><br>
<br>
<ul><li>Minimum three (3) years of clinical nursing with preferred experience home health, rehabilitation or skilled nursing care.</li><li>
Minimum two (2) years of experience in utilization or case management, discharge planning and quality improvement in a managed care or health care setting preferred.</li><li>
Preferred experience with managed care or health care delivery systems.</li><li>
CCM preferred.</li><li>
B.S. in Nursing.</li></ul><br>
PrimaryLocation : Georgia,Atlanta,Regional Office - 9 Piedmont<br>
HoursPerWeek : 40<br>
Shift : Day<br>
Workdays : Mon, Tue, Wed, Thu, Fri<br>
WorkingHoursStart : 08:30 AM<br>
WorkingHoursEnd : 05:00 PM<br>
Job Schedule : Full-time<br>
Job Type : Standard<br>
Employee Status : Regular<br>
Employee Group/Union Affiliation : GUP|UFCW|Local 1996<br>
Job Level : Entry Level<br>
Job Category : QA, UR &amp; Case Management<br>
Department : Regional Office - 9 Piedmont - UR-Care at Home - 2808<br>
Travel : No<br>
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.</div>

RN, Specialty Care Review

<div><div><b>Job Summary:</b></div><br>
<br>
<p>Responsible for coordinating care for identified members with complex medical conditions in collaboration with hospital physicians, QRM staff (IPCC, CM, SW, PTSP), practitioners, medical office staff and other providers. The goal is to support and facilitate a smooth transition from the acute care setting or skilled nursing facility to alternative levels of care or home. Collaborates with physicians, telephonic care coordinators, inpatient case management/ social workers, telephonic to create a safe discharge plan for identified complex patients. Key job functions include assessment of identified members, development of a safe discharge plan from acute inpatient, skilled nursing, LTAC and Inpatient Rehab facilities. Coordinates post-acute services and follow- up medical care to ensure continuity of care. The Acute Transitional Case Manager (TCM) will identify and communicate any barriers to discharge plan. Ensures appoints and coordination of post-acute services with vendors.</p><div><b><br>
Essential Responsibilities:</b></div><br>
<br>
<ul><li>Responsible for all transitional case management activities outlined above.</li><li>
Conducts timely reviews and refers Transitional Case Management Program or Complex Case Management within designated timeframe per policy and procedure and evaluates priority for continuity of care case management based on established guidelines.</li><li>
Performs a thorough and objective telephonic assessment of the member including physical, psychosocial, environmental, financial, and health status expectation through the use of hospital records, contact with the member/family or significant others.</li><li>
Develops an individual, mutually established plan of care based on the assessment and utilizing motivational techniques, in conjunction with the KP Hospitalists and other practitioners that identifies specific interventions, objectives and goals with anticipated targeted dates for accomplishment.</li><li>
Attends patient care conferences (rounds) as scheduled with QRM physicians, and Telephonic IPCC work together to discuss clinical course, discharge planning and provide feedback on planned interventions, or barriers to care for member self-management to avoid delays and promote smooth transition.</li><li>
Proactively, implements the plan of care and specific interventions that will lead to the accomplishment of goals as defined. This may entail implementation prior to member discharge.</li><li>
Coordinates the resources necessary to accomplish the goals,and makes recommendations for modifications to the plan of care as necessary.</li><li>
Performs telephonic outreach to identified members within 48 hours post hospital discharge and completes assessment of member status.</li><li>
Coordinates and communicates plan of care to the Primary and/or Specialist Care providers, including follow-up appointment.</li><li>
Makes referral to other KP programs for continued care support.</li><li>
Documents all case management interactions and interventions according to departmental guidelines.</li><li>
Coordinates and participates in complex case management conferences on a regular basis for members involved in the care and updates the plan of care as necessary.</li><li>
Continuously coordinates, monitors, tracks and evaluates all care and services rendered to ensure that quality care is being delivered and in the most appropriate setting.</li><li>
Re-assess and reinforce members self-management skills, including symptom and medication management.</li><li>
Acts as a resource to facility Case Managers and discharge planners.</li><li>
Provides case management updates to practitioners and health care teams.</li><li>
Collaborates with the healthcare team to provide referral information and regarding community resource referrals.</li><li>
Arranges, coordinates and facilitates appointments for the member as necessary.</li><li>
Builds effective working relationships with practitioners and other departments within the health plan.</li><li>
Works in conjunction with disease specific population based care department as appropriate.</li><li>
Consults with Chief of QRM for potential non-approvals, benefit exceptions and other issues as appropriate.</li><li>
Assists in the development of guidelines and protocols.</li><li>
Investigates, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Supervisor.</li><li>
Under the guidance of the Supervisor and in consultation with other QRM staff, participates in the coordination, planning, development, implementation, and maintenance of all QRM policies and procedures.</li><li>
Monitors utilization trends concerning inpatient and outpatient care in the market area, keeping appropriate management informed.</li><li>
Refers cases identified as risk management, peer review or quality issues to Quality and Risk Management.</li><li>
Provides documentation regarding any pertinent patient information or arrangements for inclusion in the members medical record.</li><li>
Works cross-functionally with other departments in striving to meet organizational goals and objectives.</li><li>
Participates in call rotation to support after hours and weekend referrals for quality resource management services.</li><li>
Acts as a team coach for respective areas of responsibility regarding enhanced customer service, quality of work performed and productivity of staff.</li><li>
Knowledgeable and compliant with regional personnel policies and procedures.</li><li>
Knowledgeable and compliant with QRM departmental and unit specific policies and procedures.</li><li>
Participates in annual regional and departmental compliance training.</li><li>
Knowledgeable and compliant with Principles of Responsibility.</li><li>
Develops and maintains an awareness of how to report compliance issues and concerns. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.</li><li>
Your access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform your job.</li><li>
May perform other duties as assigned.</li><li>
Other duties as assigned.</li></ul><div><b><br>
Basic Qualifications:</b></div><div>
Experience</div><ul><li>
Minimum three (3) years acute hospital discharge planning or prior experience in case management as an RN.</li></ul><div>
Education</div><ul><li>
High School Diploma or General Education Development (GED) required.</li></ul><div>
License, Certification, Registration</div><ul><li>
Registered Professional Nurse License (Georgia) OR Licensed Clinical Social Worker (Georgia) OR Licensed Master Social Worker (Georgia)</li></ul><div><b>
Additional Requirements:</b></div><ul><li>
Complex Case Management experience.</li><li>
Experience acute patient populations including Medicare members.</li><li>
Functional knowledge of computers.</li><li>
Must be able to travel within the Atlanta metro area</li></ul><div><b>
Preferred Qualifications:</b></div><ul><li>
Bachelors Degree in Nursing or four (4) years of experience in a directly related field.</li></ul><div><b>
Notes:</b></div><ul><li>
With rotating weekends</li></ul><br>
PrimaryLocation : Georgia,Atlanta,Regional Office - 9 Piedmont<br>
HoursPerWeek : 40<br>
Shift : Day<br>
Workdays : Mon, Tue, Wed, Thu, Fri<br>
WorkingHoursStart : 08:30 AM<br>
WorkingHoursEnd : 05:30 PM<br>
Job Schedule : Full-time<br>
Job Type : Standard<br>
Employee Status : Regular<br>
Employee Group/Union Affiliation : GUP|UFCW|Local 1996<br>
Job Level : Entry Level<br>
Job Category : QA, UR &amp; Case Management<br>
Department : Regional Office - 9 Piedmont - Rgnl Clinical Innovation - 2808<br>
Travel : No<br>
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.</div>

RN Quality Risk Management Acute Case Manager

Explore 710+ Case manager employment services in Atlanta this March. Find roles across top companies and apply now to boost your career.