RC Case Manager
About The Position
We provide end-to-end senior care with a specialization in dementia. As a mission-driven organization focused on delivering high-quality, value-based care to frail seniors, effective inpatient admission management is critical to supporting our patients and families. The Registered Nurse Case Manager serves as the primary clinical lead for patients at risk for hospitalization. This role is responsible for monitoring inpatient admissions, coordinating across hospital teams and internal clinicians, supporting medically appropriate utilization, and partnering with patients and families to ensure safe, timely, and well-coordinated hospital stays and transitions of care.
Requirements
- Active, unrestricted Registered Nurse license in the state of practice.
- Minimum of two years of clinical nursing experience, including at least one to two years in case management, utilization management, or care coordination.
- Experience supporting inpatient admissions, hospital transitions, or post-acute care.
- Strong clinical assessment, critical thinking, and care coordination skills.
- This is a mobile position requiring regular travel throughout the region to hospitals, care settings, and other sites as needed, including same-day travel between locations.
- Valid driver’s license in the state of employment, reliable transportation, and current automobile insurance required.
- Mileage and travel time will be compensated in accordance with company policy and applicable law.
Nice To Haves
- Experience in value-based care, managed care, PACE, or senior-focused populations.
- Experience working with cognitively impaired or medically complex patients and their families.
Responsibilities
- Coordinate and manage inpatient admissions, continued stays, and discharges to ensure medically appropriate, timely, and cost-effective care.
- Perform utilization review using medical necessity criteria and collaborate with providers and hospital-based clinicians to support appropriate level-of-care decisions.
- Serve as a clinical liaison between hospitals, internal care teams, payers, and post-acute clinicians.
- Support discharge planning and transitions of care to reduce avoidable readmissions.
- Communicate effectively with patients and families regarding hospitalization status, care plans, and discharge needs.
- Ensure accurate, timely documentation and compliance with regulatory, accreditation, and payer requirements.
- Participate in interdisciplinary care planning and escalation of complex cases as needed.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
11-50 employees
