Case Manager RN will cross train Med Surg RN

Registered Nurse (RN) Case Manager

Evening shift: 12:00 PM 8:30 PM EST, with one weekend per 4-week schedule.

Position Summary

We are seeking an experienced RN Case Manager to join a dedicated care coordination team. In this role, you will facilitate the interdisciplinary plan of care with a focus on medical necessity, patient status, level of care, and resource management. The Case Manager coordinates quality outcomes and efficient patient throughput, ensuring optimal care and appropriate utilization of hospital and community resources.

Key Responsibilities

• Perform comprehensive assessments of psychosocial and medical needs for assigned patients.
• Develop, coordinate, and document individualized case management plans of care.
• Lead interdisciplinary team meetings to plan and assess patient care needs.
• Evaluate admissions for medical necessity and appropriate level of care.
• Conduct utilization management reviews and communicate with payors.
• Serve as a liaison between physicians, patients/families, staff, and outside agencies.
• Ensure compliance with all regulatory requirements, ethics policies, and quality initiatives.
• Facilitate timely discharge planning and identify barriers to care.
• Make appropriate referrals to community, payer, and disease management programs.
• Advocate for patients with complex medical and psychosocial needs.
• Track, trend, and report variances in care processes; recommend improvement strategies.
• Participate in performance improvement and patient safety initiatives.
• Maintain punctual, dependable attendance and adhere to all departmental standards.

Qualifications

• Experience: Minimum of 3 years of recent Case Management experience in an acute care setting required.
• Experience in Med/Surg, Telemetry, Neuro, ICU, PCU, or ED strongly preferred.
• Candidates with home health or insurance case management experience considered, provided they have 3 years of total acute care experience (with at least 1 year within the last 5 years).
• Education: Associate Degree or Diploma in Nursing required; BSN preferred.
• Licensure: Current RN license (state or compact). Compact license holders must obtain state licensure within 90 days of hire.
• Certifications: Case Management, Nursing, or Utilization Review certification preferred.
• Additional: Advanced Practice Registered Nurses (APRNs) meeting compliance standards may also qualify.

Why Join

This is an opportunity to contribute to a patient-centered environment that values collaboration, quality outcomes, and compassionate care. You'll play a key role in ensuring smooth transitions of care and promoting overall wellness in every patient's healthcare journey