Nurse Case Manager

Job Description

Job Title : Nurse Case Manager

Location : On Site - Lanham, Maryland, United States

Salary : $75,000-$100,000

Skills : Care Coordination, Case Management, Clinical Assessment, Patient Advocacy, Regulatory Compliance

About the Company / Opportunity :

Join a leading organization in the hospitals and health care industry, dedicated to delivering high-quality, patient-centered care. This is an opportunity to make a significant impact on the lives of patients by supporting them through complex healthcare journeys. As a Nurse Case Manager, you will collaborate with a multidisciplinary team to ensure safe and effective transitions across the continuum of care, while promoting optimal health outcomes and resource utilization.

Responsibilities :

• Identify and prioritize patients in need of care management services using a holistic, multidisciplinary approach.
• Promote patient engagement, self-care, and treatment adherence through strategies such as motivational interviewing.
• Utilize evidence-based guidelines to verify appropriate level of care, ensure quality, and decrease unnecessary variation.
• Manage observation stay patients to facilitate timely testing, treatment, and appropriate transitions.
• Develop and coordinate comprehensive transition plans to home, community programs, or post-acute care providers, ensuring clear documentation and handovers.
• Maintain accurate, concise documentation of patient needs, care plans, and support systems in the medical record.
• Participate in clinical outcome projects and process improvement initiatives within the care management department.
• Initiate and coordinate referrals to members of the healthcare team as needed, ensuring ongoing plan of care adjustments and leadership communication.
• Apply risk and predictive analytics to identify factors affecting readmission and implement tailored interventions to support optimal patient outcomes.
• Maintain compliance with all regulatory standards, including CMS and commercial insurers.

Must-Have Skills :

Nice-to-Have Skills :