RN Case Manager-PRN

Indiana University Health • Monticello, IN

1d

About The Position

PRN/Supplemental RN Case Manager – IU White Memorial & IU Frankfort Hospitals The PRN/Supplemental RN Case Manager supports IU White Memorial and IU Frankfort hospitals by providing flexible, as-needed case management services to ensure seamless patient care coordination across the care continuum. This role involves working collaboratively with the multidisciplinary team to plan, coordinate, and facilitate patient care from pre-admission through post-discharge, ensuring optimal patient outcomes and appropriate utilization of resources.

Requirements

• Associate's Degree in Nursing required. BSN preferred.
• 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.

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.
• Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.

Responsibilities

• Support the care coordination process by assessing patient needs and developing individualized care plans.
• Ensure patients are assigned the appropriate level of care, receive necessary services, and transition smoothly to post-discharge care settings.
• Perform accurate, timely, and effective discharge planning in collaboration with clinical teams.
• Communicate with third-party payers to verify coverage and authorization requirements.
• Educate patients and families regarding care plans, medications, and health management.
• Administer education and prevention programs to promote health and wellness.
• Support hospital compliance with regulatory and payer guidelines, including Medicare, Medicaid, and commercial insurance.
• Assist with documentation and software systems such as Cerner, MCCM, SMS, and Windows applications.

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees