Registered Nurse (RN) Case Manager BayCare

Advocate Aurora Health • Green Bay, WI

416d

About The Position

The Registered Nurse (RN) Case Manager at BayCare Advocate Aurora Health is responsible for conducting comprehensive assessments, establishing care plans, and facilitating discharge planning for patients. This role emphasizes collaboration with patients, families, and healthcare teams to ensure effective transitions of care and compliance with regulatory standards. The RN Case Manager also provides case management services, manages family dynamics, and educates patients and families about available resources and services.

Requirements

• Registered Nurse License issued by the state of practice.
• Bachelor's Degree in Nursing.
• 2 years of clinical nursing experience.
• Effective communication skills.
• Ability to prioritize and organize work.
• Critical thinking and timely decision-making skills.
• Knowledge of Medicare A and B guidelines.
• Knowledge of Managed Care program requirements.
• Ability to navigate the Electronic Health Record and basic MS Office products.

Nice To Haves

• Experience in discharge planning.
• Familiarity with utilization management programs.

Responsibilities

• Conduct complete assessments and establish appropriate care plans.
• Collaborate with patients, families, and healthcare teams to achieve care goals.
• Utilize patient/family strengths in the problem-solving process.
• Provide continuity of care and discharge planning services compliant with regulatory standards.
• Participate in communication processes for smooth patient transitions.
• Manage case management services related to healthcare, finances, and family dynamics.
• Initiate internal and external referrals for timely care progression.
• Document discharge planning interventions and utilization review activities.
• Perform concurrent and retrospective reviews based on established criteria.
• Communicate effectively with the healthcare team and collaborate with social work and support personnel.
• Serve as an active member of multidisciplinary teams to resolve discharge barriers.
• Collaborate with managers and physicians on best practices for patient care.
• Refer cases to physician advisors as needed for efficient care progression.
• Complete utilization management activities and provide clinical updates to payers.
• Deliver CMS regulatory notices within established timeframes.
• Develop relationships with community-based agencies to meet patient needs.
• Educate medical and hospital staff on admission status and care coordination needs.

Benefits

• Health insurance coverage.
• 401k retirement savings plan.
• Paid time off and holidays.
• Continuing education support.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Hospitals
• Education Level: Bachelor's degree