RN Case Managers

We are seeking a compassionate and detail-oriented RN Case Manager to join our healthcare team. The ideal candidate will coordinate patient care across the healthcare continuum, ensuring optimal outcomes, efficient resource utilization, and a high standard of patient satisfaction.

Job Responsibilities :

• Reviewing the medical record of all observation and inpatient admissions and continued stays to ensure appropriate utilization and delivery of care.
• Plays an essential role in assisting physicians, nursing and staff with accurate determination of a patient’s observation status. The RN Case Manager is an important resource in preventing delayed discharges of observation patients.
• Participates in case finding and pre-admission evaluation screening to assure reimbursement.
• Assessing patient acute level of care needs and works to implement and coordinate interventions aimed at facilitating a safe and timely discharge plan to the appropriate sub-acute settings in collaboration with the Case Manager Specialist.
• Ensure that patient has received all information related to choice of follow-up care facilities according to patient and family preference and any ACO preferred contracted providers.
• Interacts, communicates, and intervenes with multi-disciplinary healthcare team in a purposeful, goal-directed fashion. Works pro-actively and utilizes critical thinking skills to maximize the effectiveness of resource utilization. Anticipates, initiates, and facilitates problem resolution around issues of resource use and continued hospitalization, discharge planning.
• Establishes and maintains effective communication with all referral sources, insurers, vendors and patient supplier systems.
• Maintains consistently a professional commitment to institutions and department’s goals and objectives. Demonstrates flexibility to the department’s needs in relation to floor and work schedule, and any other internal and external demands on the department. Continually shows commitment to the Department by extending self when need arises.
• Maintains an updated knowledge base of and references resources outlining provider benefits for care choices, including public, private, and governmental payers and established / preferred ACO relations
• Department operational excellence, regarding safe and effective discharge planning; assures department delivers quality services in accordance with applicable policies, procedures and professional standards.
• Attains all agreed to goals and objectives within specified time frames, as part of the organization’s overall mission.
• Embraces technological solutions to work processes and practices. eDischarge, EHR, Interqual, MCCM, Epic, Workday

Job Requirements :

Registered Nurse, Bachelor's prepared strongly preferred

3-5 years acute care hospital experience preferred. Critical Care or Emergency Department experience highly desirable

Required Licenses / Registrations :

RN - Registered Nurse

ACM-Accredited Case Manager or CCM-Certified Case Manager within two years of hire

Knowledge, Skills and Abilities :

Work Schedule : 4 10's or 5 8's!, weekend & holiday rotation required