RN Case Manager
TEEMA Group
Job Description
Job Description
RN Care Manager - Role Summary
The RN Care Manager plays a critical role in coordinating safe, effective, and patient-centered care across the continuum of hospital services. This position focuses on comprehensive assessment, care coordination, utilization review, and discharge planning to reduce readmissions, improve outcomes, and enhance patient and caregiver satisfaction. Working closely with interdisciplinary healthcare professionals, the RN Care Manager supports complex patient populations—particularly geriatric patients—by ensuring timely access to appropriate post-acute services and resources.
This role is ideal for experienced nurses who enjoy clinical problem-solving, collaboration, and making a measurable impact on patient outcomes and care efficiency.
Key Duties & Responsibilities
Complete comprehensive initial patient assessments in accordance with Care Management policies
Perform multidisciplinary care coordination across intra-hospital and inter-hospital levels of care
Lead transitional care planning activities, including:
Patient and caregiver education
Coordination of post-acute and aftercare services
Collaboration with commercial payers
Evaluation of high-utilizer patient root causes
Communicate and collaborate relevant patient information with appropriate members of the healthcare team
Support departmental goals related to length-of-stay reduction, readmission prevention, denial reduction, and patient satisfaction improvement
Complete documentation in accordance with departmental standards
Participate in performance improvement initiatives as needed
Perform utilization review (UR) activities in alignment with departmental policy, including:
Commercial payer reviews
Disposition determinations
Admission clinical reviews
Retroactive and self-audits
Medical necessity variance analysis
Collaborate with healthcare professionals to evaluate care needs and ensure safe discharge planning for geriatric patients across inpatient, emergency department, and surgical outpatient settings
Perform additional related duties as assigned
Required Education & Experience
Bachelor of Science in Nursing (BSN) required
Active Registered Nurse (RN) license in the state of practice
PRI Certification (must be obtained within three months of hire)
Strong computer proficiency
Desired Qualifications
Screen Certification (strongly preferred)
Care Management certification (e.g., CCM, CMC, or equivalent)
Minimum of three (3) years of clinical experience in emergency, critical care, or medical-surgical nursing
Prior case management experience
Knowledge of healthcare finance, regulatory requirements, and payer systems
Familiarity with state, local, and federal healthcare programs
Experience using Milliman or InterQual medical necessity criteria
Core Competencies
Strong two-way communication skills with the ability to clearly define expectations and actively listen
Effective delegation and team collaboration skills
Ability to remain composed under pressure and manage multiple priorities simultaneously
Physical & Mental Requirements / Work Environment
Ability to walk, stand, and sit for extended periods of time
Ability to carry necessary equipment (e.g., laptop or tablet) during rounds
Adequate manual dexterity, hand-eye coordination, and visual and auditory acuity
Ability to follow written and verbal instructions and meet regulatory requirements
Exposure to standard healthcare-related chemicals in accordance with safety guidelines
Ability to analyze complex, multidimensional problems and prioritize tasks effectively
Primary Patient Populations Served
Adult (18–64 years)
Geriatric (65+ years)
Patients with complex medical, cultural, communication, developmental, or end-of-life care needs
Patients under isolation precautions
Bariatric patients with weight-related comorbidities
Location & Work Type
Location : White Plains, New York
Work Type: On-site
Schedule: Full-time, day shift
Monday–Friday, 9:00 a.m. – 5:00 p.m.
Weekend rotation once per month (Saturday and Sunday)
If you're interested, please reply to this advertisement or directly email your resume to me at View email address on ziprecruiter.com or by calling/texting View phone number on ziprecruiter.com.
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