RN - Case Manager

Case Manager

Experience in managing acute care cases is required. Candidates must hold a BSN or MSN degree. Attendance of the flu vaccine during flu season is mandatory with no exemptions. No weekend, floating, or on-call requirements exist for this position. Candidates must not have any pending licenses and must submit an active license at the time of application. Previous charge experience is preferred. Experience with patient ratios and various patient care scenarios is advantageous. This position requires familiarity with hospital-based operations. The focus will be on care coordination, appeals and denials processes, and discharge planning. Knowledge of medical necessity guidelines, HIPAA regulations, and prior authorization processes is essential. Candidates will engage in assessments and care plans using criteria established by CMS. Unit details include managing a mix of medical and surgical patients. Staffing and scheduling practices require flexibility with no specific scheduling requests accommodated. The daily patient census is approximately 60, and the unit consists of 100 beds. Previous employment at specific healthcare facilities may require a time separation before reapplication. The candidate must provide two references from previous employment within the past year. All license and background information must be fully disclosed and reviewed. Compliance with time-off rules is essential for this position. Modules for compliance training are required and must be completed prior to commencing the position.