Registered Nurse Case Management

Role Overview This position is for a registered nurse in a full-time case management role within a hospital setting. Responsibilities include ensuring patient-centered care by validating medical necessity, advocating for benefits, and coordinating safe transitions to reduce readmissions. It involves maximizing organizational revenue through claims management, preventing denials, and managing appeals. The role also focuses on streamlining hospital workflows, coordinating multidisciplinary teams, and ensuring compliance with clinical standards and regulations to mitigate risks. Qualifications include a valid nursing license and a preferred certification as a Certified Case Manager (CCMC or ACM). Minimum experience required is 5+ years as an RN and 3+ years in case management, with hospital discharge planning experience preferred. Key skills involve strong communication, advocacy, and organizational abilities, along with knowledge of healthcare regulations. Benefits encompass comprehensive health coverage, retirement plans, paid time off, professional development, emotional support resources, family support, and additional perks. Equal opportunity employment policies are in place, and applicants are advised to be aware of fraud prevention measures during the hiring process. #J-18808-Ljbffr