Case Manager Jobs

About The Position

Requirements

• Bachelor’s degree in nursing from an accredited college or university.
• At least 5 years of nursing experience.
• Registered Nurse state licensure and/or compact state licensure upon hire.
• Basic Life Support certification from the American Heart Association upon hire.
• Demonstrated written and verbal communication skills.
• Ability to apply the nursing process to acute patient care to achieve outcomes.
• Current knowledge of the healthcare environment, including community resources and financial systems.
• Working knowledge of basic computer programs such as Word and Excel, and knowledge of smartphone use.

Nice To Haves

• Experience in a pediatric healthcare setting.
• Certified Pediatric Nurse certification.
• Nursing Case Management Board Certification from a nationally recognized case management organization.

Responsibilities

• Develop comprehensive, individualized plans of care and targeted interventions.
• Implement clinical interventions and protocols based on risk stratification and evidence-based clinical guidelines.
• Monitor patient and family responses to care plans and revise plans as needed.
• Maintain comprehensive medical record documentation in appropriate information systems and databases, following documentation and billing guidelines.
• Use electronic health record activities and reporting tools to manage preventive care and proactively reach patients most in need.
• Manage care for high-risk patients using electronic medical record outreach tools, including assessments, patient goals, and health maintenance.
• Help develop workflows to ensure patient care needs are met.
• Collaborate with providers, patients, families, and healthcare teams across care settings and in the community.
• Promote a team approach and include patients and families as active team members.
• Help ensure continuity of care beyond clinic boundaries and serve as a liaison to acute care hospitals, specialists, post-acute care services, and community agencies.
• Follow up with patients and families during transitions between care settings.
• Complete timely post-hospital follow-up, including reviewing discharge instructions, providing condition-specific education, coordinating care, and helping resolve barriers.
• Identify targeted, rising-risk, and high-risk populations using provider referrals, risk stratification, registries, and patient lists.
• Assess patients’ and families’ healthcare, educational, and psychosocial needs using standardized tools, including Nurse Case Management assessments and health risk assessments.
• Develop individualized patient and family education plans.
• Instruct and counsel patients and families about acute and chronic illnesses, prescribed treatments and medications, and care coordination.
• Provide self-management support that empowers patients and families to build self-care capacity and integrate health promotion into their lifestyles.
• Work with clinic teams and leadership to evaluate processes, identify problems, and propose or develop process-improvement strategies.