RN Case Manager

Riverview Regional Medical Center • Gadsden, AL

2d • Onsite

About The Position

We are seeking an RN Case Manager, also referred to as a Registered Nurse Case Manager or RN Clinical Case Manager. An RN Case Manager will oversee and coordinate patient care from admission through discharge to ensure quality, cost-effective outcomes. They assess patients’ needs, develop care plans, and collaborate with physicians, nurses, social workers, and other providers to manage care transitions. RN Case Managers also conduct discharge planning, utilization review, and helping patients navigate insurance and healthcare systems.

Requirements

• Valid State RN License
• BSW or other Bachelor degree in a related field
• Current CCM or obtained within 6 months of hire
• Knowledge of InterQual Criteria
• Up-to-date knowledge on Blue Cross Blue Shield Jiva Portal and BCBS experience
• Experience and knowledge in basic to intermediate computer skills
• Behavioral Violence Prevention Training within 3 months of hire and maintain current

Nice To Haves

• Minimum 5 years of acute care experience
• At least one-year experience in case management, discharge planning or management
• Current BLS (AHA) certificate
• Knowledge of Milliman Criteria

Responsibilities

• Patient Assessment: evaluate patients’ medical, psychosocial, and discharge needs upon admission and throughout their stay
• Care Coordination: develop and implement individualized care plans in collaboration with the healthcare team to ensure effective treatment and timely interventions
• Discharge Planning: coordinate safe and appropriate discharge plans, including referrals to rehab, home health, or long-term care facilities
• Utilization Review: monitor the use of hospital resources and services to ensure appropriate care and avoid unnecessary treatments or extended stays
• Patient and Family Education: help patients and families understand care plans, post-discharge instructions, and available resources
• Advocacy: advocate for patient needs and preferences, ensuring care is aligned with their goals and values

Benefits

• Competitive compensation
• Medical insurance benefit plan
• 401K

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees