Registered Nurse (RN) - Care Manager

Care Manager – Medical/Surgical

Schedule: 10-hour shifts, 40 hours per week, 4x10 schedule with no set day off. Every 6th weekend as needed. No major holidays.

Requirements:

• 3 years of experience in acute inpatient care with extensive knowledge of current medical-surgical patterns of practice.
• Experience with utilization management (UM) and case management (CM) preferred (5+ years).
• Proficiency in assessing physical and mental impairments, understanding characteristics of illness, and expected treatment.
• Knowledge of benefits, plan contracts, and eligibility issues and requirements.
• Active license as a Registered Nurse (RN).
• Electronic Medical Record (EMR) system experience, specifically EPIC.
• Preferred certifications: Certified Case Manager (CCM) or related certification.

Roles & Responsibilities:

• Assess, plan, implement, monitor, and evaluate options and services required to meet patient health needs.
• Communicate effectively to promote quality, cost-effective outcomes for assigned patients.
• Manage length of stay (LOS) and promote efficient utilization of resources.
• Determine medical necessity and appropriateness of admissions using established screening criteria.