Registered Nurse (RN) - Case Management

TLC

Portland, OR

Case Manager RN

Schedule - Weekends: Every other weekend required

Roles & Responsibilities - Coordinate patient care and facilitate discharge planning

- Assess patient needs and determine medical necessity per evidence-based guidelines

- Handle prior authorizations and manage appeals/denials

- Ensure compliance with CMS, DRG, HEDIS, NCQA, HIPAA, and The Joint Commission standards

- Collaborate with interdisciplinary team including social services

Compliance / Notes - Must have a vehicle

Travelers may be expected to float; refusal can result in termination or forfeiture of guaranteed hours

Pre-start modules: average ~16 hours (non-billable); additional annual modules required

Requested Time Off (RTO): up to 6 days total (or 3 consecutive) auto-approved; larger requests handled pre-submittal and may delay offer

Apply

Vacancy posted 9 hours ago

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