Case Manager RN

Case Manager RNThe RN Case Manager Care Coordinator is responsible for facilitating interdisciplinary care plans with a focus on medical necessity, resource utilization, and patient throughput. This role ensures high-quality, patient-centered outcomes by coordinating care, identifying barriers, and developing effective discharge plans across the continuum of care.Responsibilities:Perform comprehensive assessments of patients' medical and psychosocial needsDevelop, implement, and document individualized case management plans of careLead interdisciplinary collaboration and care coordination effortsEvaluate admissions for medical necessity and appropriate level of careConduct utilization reviews and communicate with third-party payersFacilitate patient throughput and discharge planningIdentify and address barriers to care, developing action plans for improvementAct as liaison between physicians, patients, families, and external agenciesEnsure compliance with regulatory requirements and quality standardsEducate patients and families on care plans, resources, and post-discharge needsMonitor trends in patient care barriers and recommend process improvementsSupport cost-effective care without compromising quality or safetyAdvocate for high-risk and underserved patient populationsDocument all care coordination activities and recommendations accuratelyParticipate in performance improvement and patient safety initiativesRequirements:Minimum 3 years of recent case management experience in an acute care setting requiredOR 3 years of acute care RN experience in Med/Surg, Tele, Neuro, ICU, PCU, or EDHome health or insurance case management experience considered if candidate has:3+ years total acute care experienceAt least 1 year of acute care experience within the last 5 yearsAssociate Degree in Nursing required; BSN preferredActive Florida RN license or compact license required (Florida licensure within 90 days if compact)Case Management, Nursing, or Utilization Review certification preferredAPRN license acceptable if applicableSchedule:Full-timeDay shift: 8:00 AM – 4:30 PM EST1 weekend every 4 weeksSetting:Acute care hospital250+ bed facilityOffers comprehensive services including behavioral health, NICU, cardiac, stroke, surgical, and rehabilitation programsBenefits:Comprehensive medical, dental, and vision coveragePrescription, behavioral health, and telemedicine services401(k) with employer matchEmployee stock purchase planTuition assistance and student loan supportPaid time off and family leave programsLife, disability, and supplemental insurance optionsEmployee wellness and counseling resourcesChildcare, eldercare, and lifestyle support servicesDiscounts and financial planning resourcesAdoption assistance and fertility benefitsEEO Statement - Tribal Health is proud to be an Equal Opportunity Employer. We comply with all applicable federal, state, and local laws regarding non-discrimination. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.