Nurse Care Manager

Northwestern Medical Center • St. Albans, VT

15h

About The Position

Northwestern Medical Center is recruiting a full-time Nurse Care Manager in Case Management. The role conducts individualized concurrent clinical evaluations, reviews medical records for medical necessity, develops personalized action plans, educates patients, makes post-acute care referrals, and monitors and adjusts care plans as patients progress. The Nurse Care Manager provides clinical information to health insurers and works with interdisciplinary teams and technology to identify and manage high-risk, complex cases, coordinate community-based and transitional care, and support effective discharge planning.

The position partners with physicians, nurses, patients, caregivers, families, community agencies, and other healthcare professionals to support treatment adherence, medication compliance, care transitions, and patient outcomes. It guides and advocates for patients and families as they navigate the healthcare system, coordinates community resources, and maintains accurate and timely records. The work takes place in an intensive, fast-paced environment with minimal supervision. The primary schedule is 8:00 a.m. to 4:30 p.m., with weekends as needed. The hiring range is $35–$55.94. The position is represented by a labor union, and wages, benefits, and certain employment terms are governed by the applicable collective bargaining agreement.

Requirements

• Graduate of an accredited school of licensed practical nursing or registered nursing.
• Current Vermont licensure as a Registered Nurse or Licensed Practical Nurse.
• Ability to work in an intensive, fast-paced environment with minimal supervision.
• Moderate physical activity, including manual dexterity, visual acuity, and mobility.
• Use required personal protective equipment according to policy and patient situation or condition.

Nice To Haves

• BSN or MSN strongly preferred.
• Three years of experience in a hospital and/or clinic setting preferred.
• Utilization management, case management, or community care management experience preferred.
• Certified Case Manager preferred.

Responsibilities

• Conduct individualized concurrent clinical evaluations of patients, their health needs, and concerns.
• Review patient medical records for medical necessity and appropriateness of admission using established criteria.
• Develop personalized action plans, provide patient education, issue referrals for post-acute care, monitor progress toward goals, and modify care plans as needed.
• Provide clinical information and updates regarding plans of care to health insurers and other payors as required.
• Work with interdisciplinary care teams and technology to identify and manage high-risk, complex cases; coordinate care planning, referrals, community-based care, and transitions.
• Build team-oriented working relationships with physicians, nurses, and other healthcare professionals; evaluate and report on patient health outcomes.
• Direct and participate in discharge planning, including treatment adherence, medication compliance, post-discharge planning, and addressing barriers to discharge.
• Include patients and caregivers in transition planning and assist patients moving from inpatient hospital care to post-discharge services.
• Advocate for decreased hospital stays when appropriate and communicate with providers about level of care, resource use, payor requirements, and discharge plans.
• Guide and advocate for patients, caregivers, and families navigating the healthcare system; coordinate community resources to support transitions.
• Maintain accurate and timely records of patient-related interactions.
• Collaborate with internal staff and outside agencies to meet patient and family needs.
• Collaborate with DCF/APS on matters involving children and vulnerable adults and file reports as required by law.
• Provide patients of all ages with information about available resources and services, and use community service providers to support their ability to function in the community.
• Refer adult patients to social service agencies regarding financial concerns.
• Support patients and families through transitions, including coordinating support for postpartum mothers and infants and providing information about end-of-life care options.
• Support patients' and families' emotional needs when discussing long-term care placement, while respecting concerns about loss of independence.
• Support emotional and clinical needs related to chronic disease management and diagnosis.
• Coordinate post-discharge support systems and services, and communicate with long-term care facilities and home health agencies to facilitate return to the community.
• Provide age-appropriate information to patients and families, act as a liaison between providers and patients or families, answer questions, clarify issues, and explain medical recommendations.
• Collect data related to length of stay, denied days, resource consumption, and patterns, and explore strategies to manage utilization and reduce variation.

Benefits

• Generous benefits package with recognized national carriers, designed to support employee health and well-being, work-life balance, asset protection, and financial security.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree