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Nurse Case Manager

Nurse Case Manager

TalentlyLanham, MD, United States
4 days ago
Job type
  • Full-time
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 :

  • Current licensure as a registered nurse by the Maryland Board of Nursing.
  • BSN or ADN with equivalent experience, with BSN required within 5 years of start date.
  • Minimum of three years’ experience in a clinical, ambulatory, or post-acute care setting.
  • Expertise in case management, care coordination, and interdisciplinary collaboration.
  • Strong documentation and communication skills.

    • Nice-to-Have Skills :

  • Care coordination experience in a hospital or similar environment.
  • Experience with evidence-based guideline tools such as InterQual.
  • Familiarity with Epic or other electronic health record (EHR) systems.
  • Knowledge of regulatory requirements for Medicare, Medicaid, and commercial insurers.
  • Participation in quality improvement or clinical outcome projects.
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    Nurse Case Manager • Lanham, MD, United States