Nurse (Case Management)

Job Title

Registered Nurse

Duties

Perform ongoing assessment of patients requiring care coordination, including patients who do not keep appointments, leave against medical advice, or present frequently to the Emergency Department (ED).

Collaborate with ED providers and the Resource Management Team (RMT) to determine medical necessity and level-of-care appropriateness using CMS-approved criteria for inpatient and outpatient referred care.

Participate in case management conferences across disciplines, families, and outside agencies; serve as patient and family advocate throughout the continuum of care.

Collects and maintains case management data, including service utilization, identified barriers, interventions, and patient outcomes.

Use patient data to identify care gaps, improve coordination processes, and support quality improvement efforts.