Nurse Case Manager

Nurse Case Manager

The Nurse Case Manager is a pivotal member of the interdisciplinary healthcare team, responsible for coordinating a patient-centered plan of care from admission through transition. By integrating clinical expertise with resource management, you will ensure that patients receive high-quality, cost-effective care in the most appropriate setting. You will act as a primary advocate for patients and families, navigating complex healthcare systems to ensure safe and seamless transitions.

About Speare Memorial Hospital

Speare Memorial Hospital is a 25-bed critical access hospital serving dozens of communities in the Lakes Region. We are passionately committed to providing exceptional, local care to our friends, families, neighbors, and communities at large.

Mission: To work together to serve the needs of our patients and community.

Vision: A community where all can achieve optimal health.

Values: Kindness, Collaboration, Patient & Family-Centered, Safety, Excellence, Efficiency, and Professionalism.

What You'll Do:

1. Care Coordination & Planning

• Conduct intake assessments to identify clinical, psychosocial, and financial needs.
• Develop and implement individualized transition plans in collaboration with physicians, nursing staff, and therapy teams.
• Participate in interdisciplinary rounds (IDRs) to advance the care plan and address barriers to discharge.
• Coordinate patient and caregiver education to ensure readiness for post-acute care.

1. Utilization Management

• Perform concurrent and retrospective reviews using evidence-based criteria to determine the appropriate level of care (Inpatient vs. Observation).
• Communicate clinical necessity to third-party payers to secure authorizations and minimize denials.
• Monitor hospital resource utilization and length of stay (LOS) to promote efficiency and financial stability.
• Manage the appeals process for clinical denials in collaboration with the Physician Advisor

1. Advocacy & Quality Improvement
• Advocate for patient rights and access to services within the constraints of insurance benefits and regulations.
• Identify opportunities for quality improvement and participate in initiatives to enhance patient outcomes.
• Maintain an up-to-date knowledge of community resources, including home health, durable medical equipment (DME), and skilled nursing facilities (SNF).

What We're Looking For:

Required:

• Graduate of an accredited School of Nursing with a valid Registered Nurse (RN) or Licensed Practical Nurse (LPN) license in the state of New Hampshire
• 2 years of recent clinical nursing experience in an acute care setting
• BLS certification
• Skills & Attributes
  • Customer Service: Demonstrates a commitment to service excellence by treating patients, families, and interdisciplinary colleagues with empathy, respect, and professionalism.
  • Collaboration: Partners effectively with physicians and the interdisciplinary team. Promotes a unified approach to care through active teamwork and shared problem-solving.
  • Autonomy & Flexibility: Displays high levels of creativity and independence in managing caseloads, with the ability to adapt quickly to changing patient needs or organizational requirements.
  • Critical Thinking: Ability to apply purposeful, organized thinking to make sound clinical judgments and solve complex patient situations efficiently.
• Technical Proficiency: Strong computer skills with the ability to navigate Electronic Medical Records (EMR) and utilize resource management software effectively

Preferred:

• Prior experience in Case Management, Utilization Review, or Discharge Planning
• Proficiency with Electronic Medical Records (EMR) and utilization review software.

Why Join Speare Memorial Hospital?

• Community Connection: Be part of an organization deeply invested in local health and wellness.
• Collaborative Culture: Work alongside dedicated professionals who genuinely care about their work and each other.
• Professional Growth: Opportunities for continuing education and career development.
• Comprehensive Benefits
  • Competitive salary
  • Health, dental and vision insurance
  • Health savings accounts with employer contributions
  • 403(b) retirement plans with generous employer contributions
  • Lifestyle Savings Account reimbursement program
  • Tuition Assistance and Student Loan Repayment programs
  • Employee recognition and appreciation programs
  • Generous Earned Time accrual
  • Short-Term & Long-Term Disability
  • Life insurance

Our Commitment

Speare Memorial Hospital is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that a diverse workforce strengthens our ability to serve our equally diverse community.

Join us in our mission to provide compassionate, high-quality healthcare to our community.