RN Case Manager-Weekends

Job Description

Registered Nurse Case Manager (RN) - Weekend Program

Schedule: Friday through Monday

• Friday: 8:00 AM - 4:30 PM
• Saturday: 8:00 AM - 8:30 PM
• Sunday: 8:00 AM - 8:30 PM
• Monday: 8:00 AM - 4:30 PM

Position Summary

The Registered Nurse Case Manager serves as an integral member of the interdisciplinary care team, coordinating and facilitating patient care across the continuum from pre-admission through post-discharge. This role is responsible for ensuring patients receive the appropriate level of care, timely access to services, and safe, effective transitions to the next level of care.

The RN Case Manager collaborates closely with physicians, nursing staff, social workers, and community resources to promote optimal patient outcomes, effective resource utilization, and regulatory compliance. The ideal candidate is a clinically experienced nurse with strong critical thinking skills and a passion for patient advocacy and care coordination.

Previous inpatient hospital case management experience is strongly preferred.

Key Responsibilities

• Coordinate and manage patient care throughout the hospitalization and discharge process.
• Conduct comprehensive assessments to determine appropriate level of care and resource needs.
• Facilitate timely and effective discharge planning to ensure safe transitions across the continuum of care.
• Collaborate with multidisciplinary teams to develop and implement patient-centered care plans.
• Monitor patient progression and identify barriers to discharge, proactively coordinating solutions.
• Partner with insurance providers and third-party payers to obtain authorizations, ensure coverage, and promote appropriate utilization of healthcare services.
• Review clinical documentation and patient status utilizing established criteria and regulatory guidelines.
• Participate in denial prevention efforts and assist with appeals when necessary.
• Provide patient and family education related to care transitions, available resources, and prevention initiatives.
• Maintain compliance with federal, state, payer, and organizational requirements related to case management and utilization review.

Qualifications

• Associate's Degree in Nursing required. BSN preferred.
• Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.
• Certification in Case Management preferred.
• Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
• Ability to comprehend third party contractual arrangements is preferred.
• Understanding of the third party denial and appeal process is preferred.
• Requires knowledge of various software applications including Windows; Cerner; CarePort; and SMS.
• 3-5 years of experience required.
• Requires strong clinical background in acute care.

About Us

• Indiana University Health has nearly 40,000 team members, including more than 3,600 physicians and 1,200 advanced practice providers, and we're home to the largest nursing network in Indiana with more than 9,000 nursing team members at over 800 sites of care.
• IU Health is ranked No. 1 in Indiana by U.S. News & World Report, Riley Children's Health is ranked among the top children's hospitals in the country by U.S. News & World Report.
• A unique partnership with the Indiana University School of Medicine - one of the nation's largest medical schools - gives patients access to groundbreaking research and innovative treatments, and it offers team members access to the latest science and the very best training - advancing healthcare for all.
• With 15 hospitals, including seven with Magnet designation and eight with Pathways to Excellence designation, our team members are leading the way through excellence.
• At Indiana University Health, your personal and professional growth is a top priority. You will have access to many diverse opportunities to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development, promotion opportunities and cross training development.
• Indiana University Health is invested in the lives of Hoosiers, leading the transformation of healthcare to make Indiana one of the nation's healthiest states.

About the Team

Indiana University Health is Indiana's most comprehensive health system, with 15 hospitals and nearly 40,000 team members serving Hoosiers across the state. We're looking for team members who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day.