Case Manager RN

Case Manager RN

The RN Case Manager Care Coordinator is responsible for facilitating interdisciplinary care plans with a focus on medical necessity, resource utilization, and patient throughput. This role ensures high-quality, patient-centered outcomes by coordinating care, identifying barriers, and developing effective discharge plans across the continuum of care.

Responsibilities:

• Perform comprehensive assessments of patients' medical and psychosocial needs
• Develop, implement, and document individualized case management plans of care
• Lead interdisciplinary collaboration and care coordination efforts
• Evaluate admissions for medical necessity and appropriate level of care
• Conduct utilization reviews and communicate with third-party payers
• Facilitate patient throughput and discharge planning
• Identify and address barriers to care, developing action plans for improvement
• Act as liaison between physicians, patients, families, and external agencies
• Ensure compliance with regulatory requirements and quality standards
• Educate patients and families on care plans, resources, and post-discharge needs
• Monitor trends in patient care barriers and recommend process improvements
• Support cost-effective care without compromising quality or safety
• Advocate for high-risk and underserved patient populations
• Document all care coordination activities and recommendations accurately
• Participate in performance improvement and patient safety initiatives

Requirements:

• Minimum 3 years of recent case management experience in an acute care setting required
• OR 3 years of acute care RN experience in Med/Surg, Tele, Neuro, ICU, PCU, or ED
• Home health or insurance case management experience considered if candidate has:
• 3+ years total acute care experience
• At least 1 year of acute care experience within the last 5 years
• Associate Degree in Nursing required; BSN preferred
• Active Florida RN license or compact license required (Florida licensure within 90 days if compact)
• Case Management, Nursing, or Utilization Review certification preferred
• APRN license acceptable if applicable

Schedule:

• Full-time
• Day shift: 8:00 AM 4:30 PM EST
• 1 weekend every 4 weeks

Setting:

• Acute care hospital
• 250+ bed facility
• Offers comprehensive services including behavioral health, NICU, cardiac, stroke, surgical, and rehabilitation programs

Benefits:

• Comprehensive medical, dental, and vision coverage
• Prescription, behavioral health, and telemedicine services
• 401(k) with employer match
• Employee stock purchase plan
• Tuition assistance and student loan support
• Paid time off and family leave programs
• Life, disability, and supplemental insurance options
• Employee wellness and counseling resources
• Childcare, eldercare, and lifestyle support services
• Discounts and financial planning resources
• Adoption assistance and fertility benefits

EEO Statement - Tribal Health is proud to be an Equal Opportunity Employer. We comply with all applicable federal, state, and local laws regarding non-discrimination. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.