Home Health RN Case Manager

Making family care possible. At Abby Care, we are tackling one of the most important and unsolved challenges of our time: family caregiving.

Over 50 million Americans are family caregivers for loved ones without pay, tools, or support. Our mission is clear and ambitious: to train and employ family caregivers so they can get paid for the care they already provide at home.

Abby Care is building a tech-powered, family-first care platform to efficiently deliver care, improve health outcomes, and provide the best-in-class experience nationwide.

We are rapidly expanding our mission and looking for passionate team members to join. Abby Care has partnered with leading insurance plans, healthcare providers, and community organizations. We’re supported by top, mission-driven VCs to empower families throughout the country.

We're looking for a passionate Registered Nurse to join our team as a RN Case Manager. This role will report into the Director of Nursing in Pennsylvania. This is a Full-Time opportunity based in Gettysburg, PA.

The RN Case Manager at Abby Care provides the comprehensive care and coordination of services for patients within their caseload. This role requires a nurse with excellent organizational skills, strong communication abilities, and a dedication to providing high-quality patient care. The RN Case Manager will work closely with patients, families, Primary Care Physicians (PCPs), therapy providers, and internal support teams to ensure optimal patient outcomes.

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• Manage a diverse caseload, ensuring quality patient care and efficient care coordination.

• Provide coaching, oversight, and support to Home Health Aides (HHAs) to ensure high-quality patient care and adherence to clinical standards.

• Develop and implement individualized care plans based on patient assessments and goals.

• Coordinate with PCPs, therapy providers, and internal support teams to ensure comprehensive care.

• Provide education and support to patients and families regarding their health care needs and treatment plans.

• Maintain accurate and timely electronic charting, with a preference for real-time documentation.

• Ensure all documentation meets regulatory and Abby Care standards, with a minimum of 24-hour turnaround time.

• Establish and maintain effective communication with PCPs, therapy providers, and internal support teams.

• Escalate appropriate issues to Clinical Leads in a timely manner, such as order management and patient concerns.

• Participate in on-call rotation (approximately one weekend per month), holiday rotation, and possible phone triage night coverage during weekdays.

• Achieve caregiver satisfaction by providing high-quality, compassionate care and support.

• Monitor and work to improve patient readmission rates.

• Ensure extended visits remain within acceptable ranges and administrative tasks (e.g., mileage reimbursements) are completed thoroughly.

• An Associate's Degree or A Baccalaureate School of Nursing Degree.

• Current and valid license as a Registered Nurse in the state of Pennsylvania.

• 2 years of experience as a Registered Nurse in a clinical setting; 1 year of home health experience preferred.

• Case management/supervisor experience and pediatric/adult care experience preferred.

• Knowledge of Medicaid paid family caregiving program and HHA scope of practice preferred (training provided if needed).

• Reliable transportation, valid driver's license, and current auto insurance required.

• Ability to work flexible hours, travel locally, and provide on-call service to patients/families.

• Knowledge of OASIS preferred (training provided if needed).