Job Summary
The Registered Nurse – Case Management is responsible for coordinating patient care across the continuum, ensuring quality outcomes, cost-effective treatment, and appropriate resource utilization. This role involves collaborating with physicians, patients, families, and interdisciplinary teams to develop and implement individualized care plans that support safe transitions and optimal health outcomes.
Key Responsibilities
- Assess patient needs and develop individualized care plans in collaboration with physicians and interdisciplinary teams.
- Coordinate patient care services, including discharge planning and transitions of care.
- Monitor patient progress and adjust care plans as needed to ensure quality outcomes.
- Serve as a liaison between patients, families, healthcare providers, and insurance representatives.
- Educate patients and families on treatment plans, resources, and community support services.
- Document assessments, interventions, and outcomes in compliance with hospital and regulatory standards.
- Ensure compliance with case management policies, procedures, and applicable regulations.
- Participate in interdisciplinary team meetings and contribute to care planning discussions.
Required Qualifications
- Current Registered Nurse (RN) license in the state of practice.
- Associate’s Degree in Nursing (ADN) required.
- Must have at least 2 years of recent experience in the specialty within the past 2 years.
- Strong clinical assessment and critical thinking skills.
- Excellent communication and interpersonal skills.
- Proficiency in electronic medical records (EMR) systems.
Preferred Qualifications
- Bachelor of Science in Nursing (BSN).
- Prior experience in hospital case management or utilization review.
- Knowledge of Medicare/Medicaid regulations and insurance processes.
Certifications
- Basic Life Support (BLS) certification required.
- Case Management Certification (CCM or ACM) preferred.