Registered Nurse (RN) Case Manager
About The Position
The RN Case Manager facilitates care across the continuum through effective resource coordination, helping patients achieve optimal health, access care, and appropriately use resources while respecting their resources and right to self-determination. The role ensures that care is provided at the appropriate level based on medical necessity and assesses patients’ transition needs to support timely throughput, safe discharge, and prevention of avoidable readmissions. The position integrates national case management standards through utilization management, transition management, care coordination, regulatory and accreditation compliance, and education for physicians, patients, families, and caregivers. Responsibilities include supporting medical necessity and denial prevention, promoting appropriate length of stay and patient satisfaction, and ensuring care is delivered in the right sequence and at the appropriate level.
Requirements
- Graduate of an accredited school of nursing.
- Two years of acute hospital patient care experience.
- RN license.
- Currently licensed, certified, or registered to practice the profession as required by law or regulation in the state of practice or by policy.
- Active RN license for the state or states covered.
Nice To Haves
- Academic degree in nursing (bachelor's or master's).
- Acute hospital case management experience.
- Accredited Case Manager (ACM) certification.
Responsibilities
- Accurately screen for medical necessity and submit cases for Physician Advisor review.
- Identify complex patients and refer them to Social Work Services.
- Collaborate with physicians, office staff, and ancillary departments.
- Complete timely, concise documentation in the Case Management system.
- Identify and document potentially avoidable days.
- Identify and report overutilization and underutilization.
- Perform related duties as required.
Benefits
- Medical, dental, vision, and life insurance.
- 401(k) retirement savings plan with employer match.
- Paid time off.
- Career development and continuing education opportunities.
- Health savings accounts and healthcare and dependent flexible spending accounts.
- Employee Assistance Program.
- Employee discount program.
- Voluntary benefits including pet insurance, legal insurance, accident and critical illness insurance, long-term care, elder and childcare, and auto and home insurance.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
