RN Case Manager

Indiana University Health•Indianapolis, IN

10h•Hybrid

About The Position

Riley Children's Health, Indiana’s largest pediatric healthcare provider with over 50 locations across the state, is seeking an RN Case Manager to join our dedicated team. As one of the nation’s leading pediatric healthcare networks, we offer comprehensive care through a multidisciplinary approach that covers all aspects of pediatric health. Our reputation for excellence is affirmed by our status as Indiana's only pediatric research hospital and our ranking among the top hospitals nationally, as recognized by U.S. News & World Report. Riley Children's Hospital in Indianapolis has an amazing opportunity for the right candidate. While prior pediatric experience is helpful, it is not a strict requirement. This full-time position works Monday-Friday, day shift with the ability to work remotely on Wednesdays upon completion of training and onboarding. If you are ready to advance your nursing career with Indiana's premier healthcare system, we encourage you to apply today!

Requirements

Associate's Degree in Nursing required. New ASN RNs hired after January 1, 2013, will be required to complete their BSN within 5 years of hire date.
Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.
3-5 years of experience required.
Requires strong clinical background in acute care.
Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.

Nice To Haves

Certification in Case Management preferred.
Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
Ability to comprehend third party contractual arrangements is preferred.
Understanding of the third party denial and appeal process is preferred.

Responsibilities

Collaborating with a multidisciplinary team to assign appropriate levels of care.
Ensuring patients receive necessary services and are transitioned smoothly to the right post-discharge care.
Conducting timely and effective discharge planning.
Coordinating with third-party payers to secure coverage.
Implementing educational and preventive programs for patients.