RN - Case Manager

Case Manager RN

Job Title: Case Manager RN

Profession: Registered Nurse

Specialty: Case Manager

Duration: 13 weeks

Shift: Day Hours per Shift: 5x8 (08:00 - 16:30)

Experience: Minimum 2 years of charge experience required

License: Must have an active state RN license

Certifications: BLS, Care Management certification preferred

Must-Have:

• Experience with an electronic charting system
• Required experience in acute hospital settings
• Familiarity with CMS guidelines and HIPAA regulations

Description:

The Case Manager RN will be responsible for all medical and surgical patients on the unit, including ICU and IMC. This position requires care coordination, discharge planning, and disease management. The candidate will assist with benefits eligibility, appeals and denials, and continued stay reviews. Candidates should have experience with ICD 10 coding, CPT coding, and DRG. Knowledge of patient assessment and determination of medical necessity is essential. This role does not require weekends or holidays. Candidates will need to be comfortable floating within their scope of practice. Familiarity with trauma level care and long-term acute care is preferred but not required. Applicants should be prepared to manage the workload associated with a daily census of 25 patients. Prior authorization experience is necessary for this role. The Case Manager will collaborate with interdisciplinary teams, including social services and interpretation services. Comprehensive knowledge of the Joint Commission standards and core measures is important.