Nurse Case Manager

Position Summary A healthcare organization is seeking a Registered Nurse (RN) Case Manager to support a coordinated, multidisciplinary approach to patient care across the care continuum. This role is responsible for assessing, planning, coordinating, and evaluating patient care needs while serving as a clinical resource for patients, families, physicians, and care teams. The Nurse Case Manager plays a key role in facilitating safe, efficient, and effective care delivery by ensuring appropriate utilization of healthcare services and supporting optimal patient outcomes across inpatient and post-acute settings. Education & Experience Graduation from an accredited school of nursing required Minimum of three (3) years of clinical nursing experience in an acute care hospital setting Minimum of three (3) years of experience in Case Management, Discharge Planning, or Utilization Review Licensure & Certification Active Registered Nurse (RN) license in the state of practice (e.g., Nevada or equivalent) Current Basic Life Support (BLS) certification from the American Heart Association (AHA) Additional & Preferred Qualifications Recent, documented experience in acute care hospital settings preferred Experience in one or more of the following areas strongly preferred: Pediatric case management Emergency Department (ED) clinical experience Utilization Review or Discharge Planning Professional certification preferred, including: Certified Case Manager (CCM) Accredited Case Manager (ACM) Membership in professional organizations such as: Commission for Case Manager Certification (CCMC) American Case Management Association (ACMA) Strong understanding of healthcare reimbursement models and regulatory requirements Knowledge Case management principles and nursing process standards Disease processes and standards of care across multiple specialties Patient care planning, assessment, and outcome evaluation techniques Nurse Practice Act, compliance standards, and regulatory requirements Third-party reimbursement systems and utilization management principles Hospital safety protocols, infection control, and patient rights Emergency response procedures and age-specific care considerations Skills & Abilities Manage patients with varying acuity levels across the care continuum Analyze and interpret clinical documentation and medical records effectively Apply utilization management and reimbursement guidelines appropriately Use healthcare systems, electronic medical records, and case management tools proficiently Communicate clearly and effectively with diverse patient populations in high-stress environments Build and maintain collaborative working relationships with interdisciplinary healthcare teams Demonstrate strong organizational skills and attention to detail in clinical documentation and coordination Ensure safe, effective, and compliant use of clinical tools and healthcare systems #J-18808-Ljbffr