Nurse (Case Management)

Duties

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Managed complex chronic, acute, and multi-system patient caseloads through assessment, care planning, discharge coordination, follow-up, education, and advocacy.

Applied independent clinical judgment to complex cases, adapting interventions, addressing barriers to care, and supporting staff with case management challenges.

Provide outpatient case management by coordinating multidisciplinary care, referrals, authorizations, transitions, and follow-up; facilitated communication across providers and care settings and tracked services to ensure timely, continuous care.

Provide patient education and health coaching on disease management, medications, self-care, and follow-up to promote engagement and adherence.

Provide direct outpatient nursing care through in-person and telehealth encounters, including assessment, treatment, follow-up, documentation, patient education, and safety monitoring.

Analyze case management data and care gaps to improve coordination, recommend program and process enhancements, support policy development, and serve as a clinical resource to nursing and interdisciplinary staff.