Registered Nurse - (RN) - Case Manager - FT - Days

Northeast Georgia Health System•Gainesville, GA

About The Position

The Registered Nurse Case Manager provides comprehensive assessment, planning, implementation, and evaluation of individual patient needs. The role collaborates with physicians, patients and families, nursing, utilization review, and other healthcare team members to align patient management and resource use with clinical, quality, and cost-effective outcomes. The Case Manager coordinates a team approach to achieve expected patient outcomes and appropriate transitions to the next level of care; manages length of stay and regulatory compliance; and participates in interdisciplinary rounds on the assigned unit. The role also coordinates with community providers on post-hospitalization care needs. The position serves patients across neonatal, infant, child, adolescent, adult, and geriatric age groups, following population-specific clinical guidelines and National Patient Safety Guidelines. It provides cross-coverage for RN Case Managers across care settings as required, including remote coverage and weekend rotation.

Requirements

Active license to practice as a Registered Nurse in Georgia.
Associate degree and graduation from an accredited school of nursing.
Three to five years of experience in direct patient care and/or case management.
Financial and discharge planning experience.
Aptitude in critical care, cardiac, medical, and/or surgical nursing.
Working knowledge of applicable state and federal regulations.
Excellent observation, analytical thinking, and problem-solving skills; ability to work independently.
Excellent oral and written communication skills.
Interpersonal skills including professionalism, teamwork, and a positive approach.
Ability to develop creative and effective solutions to problems and opportunities.

Nice To Haves

Case Management Certification (CCM) or American Case Management (ACM) certification.
Bachelor's degree.

Responsibilities

Monitor patients on assigned units to ensure appropriate use of resources and interventions and manage length of stay based on working DRG or admitting diagnosis.
Communicate expected length of stay and progress toward discharge with physicians, patients and families, and other disciplines.
Coordinate and oversee patient care to ensure interventions occur in sequence and processes are timely; identify potential service delays and escalate unresolved issues to management.
Assess, coordinate, and facilitate discharge plans, ensuring post-acute needs are arranged before discharge and plans are regularly reassessed for safe, timely transitions.
Explain the plan of care, discharge arrangements, and potential financial responsibilities for inpatient and post-hospitalization services to patients and families.
Maintain knowledge of reimbursement methodologies and coverage guidelines, and communicate as needed to ensure services are covered.
Coordinate daily with Utilization Review Nurses to confirm patient status and level of care, facilitating changes through communication with physicians, mid-level providers, or nursing staff.
Act as a liaison among patients and families, physicians, nursing staff, and other disciplines to support optimal discharge planning and outcomes.
Lead discharge planning, social service coordination, community resource referrals, and communication of financial information on the assigned unit.
Support a customer-service-oriented environment and collaborative practice, including appropriate handoff communication during patient transfers between units.
Maintain a positive attitude, communicate appropriately, respond constructively to change, and suggest effective workflow changes as needed.
Maintain knowledge of community resources, governmental regulations, and third-party payers to facilitate appropriate outcomes.
Adhere to regulatory and DNV requirements and payer regulations; complete required paperwork.
Work scheduled shifts, including weekend rotation and remote coverage, and demonstrate urgency while supporting financial stewardship.