TN - RN Case Manager

About the role

Abby Care is seeking an experienced and dedicated RN Case Manager to join our growing team in Nashville, Tennessee. In this critical role, you will serve as the clinical anchor for patient care, owning the end-to-end coordination and oversight of complex patient cases. You will act as a direct advocate for patients and families, ensuring that care plans are not only medically sound but also practically executable within the home environment. This position requires a high level of clinical judgment and ownership, as you supervise the work of Home Health Aides and Certified Nursing Assistants to guarantee adherence to strict clinical standards. You will translate medical jargon into actionable steps for families, providing education and support that empowers them to confidently manage daily care routines. Success in this role means building trusting partnerships with physicians and therapy providers to align treatment goals and resolve care barriers proactively. You will leverage the Abby Care platform to drive documentation accuracy and care delivery efficiency, ensuring that every patient interaction is captured and optimized for better outcomes. Ultimately, your work will directly influence the quality of care delivered at home, helping to reduce hospital readmissions and improve the overall patient experience. This is a hands-on leadership role where your expertise and diligence will shape the care journey for multiple families across the Nashville area.

Key facts

What you'll do

• Coordinate comprehensive patient care by managing a diverse caseload and collaborating with primary care providers, therapy teams, and internal support staff to achieve optimal clinical outcomes.
• Provide direct clinical oversight to Certified Nursing Assistants and Home Health Aides, coaching them on best practices and ensuring strict compliance with care standards.
• Develop and implement highly individualized care plans based on detailed patient assessments, medical history, and specific health goals.
• Maintain rigorous electronic documentation with a strong preference for real-time charting, ensuring all entries meet a minimum 24-hour turnaround time in line with regulatory requirements.
• Educate and support patients and their families on complex care plans, delivering clear instructions and emotional guidance to enhance confidence in home-based care.
• Manage clinical escalations efficiently, identifying issues related to order management or urgent patient needs and escalating them promptly to Clinical Leads.
• Participate in scheduled on-call rotations, including approximately one weekend per month, holiday coverage, and weekday phone triage during night shifts.
• Drive continuous quality improvement by monitoring patient readmission rates and working closely with caregivers to elevate satisfaction scores.
• Ensure accuracy in administrative tasks, including completing mileage reimbursements and keeping extended clinical visit durations within acceptable parameters.
• Act as the central point of contact for interdisciplinary communication, aligning all parties involved in the patient's care pathway.

Requirements

• Possess an Associate's Degree in Nursing or a Baccalaureate School of Nursing Degree (BSN) from an accredited institution.
• Hold a current, valid, and unencumbered Registered Nurse license issued by the state of Tennessee.
• Maintain a valid Compact or Multi-state RN license that allows for practice within the state.
• Have a minimum of 2 years of recent clinical experience working as a Registered Nurse in a healthcare setting.
• Demonstrate the ability to access reliable transportation for local travel to patient homes and clinical sites.
• Possess a valid driver's license and current auto insurance that satisfy company policy for field visits.
• Show flexibility in scheduling, including the capacity to work varied hours and adapt to urgent patient needs.
• Commit to participating in on-call schedules that include weekends, holidays, and overnight phone coverage.
• Exhibit strong organizational skills and attention to detail, particularly in high-pressure care coordination scenarios.
• Uphold strict confidentiality and compliance with all healthcare regulations in every patient interaction.

Practical notes

This role is Full-Time and Hybrid, based in Nashville, TN. It requires local travel to patient locations, participation in on-call rotations, and adherence to night phone triage schedules as needed.