RN Case Manager per-diem
Core
Autonomous RN Case Manager coordinating care, discharge planning, and resource utilization for complex patients to ensure quality, cost-efficient outcomes and medical necessity compliance.
Role type
RN Case Manager
Builds
Safe and timely discharge plans and coordinated care transitions
Domain
Healthcare / Case Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Clinical assessment, discharge planning, resource coordination, insurance coverage verification, medical necessity determination, interdisciplinary collaboration, regulatory compliance, data analysis, patient advocacy
Preferred skills
Case management certification, InterQual certification, Lean principles knowledge
Technologies
eDischarge, EHR, Interqual, MCCM, Epic, Workday
Responsibilities
Review medical records to determine medical necessity for admission and continued stays; coordinate discharge planning and arrange referrals to sub-acute settings; communicate with physicians and payers regarding coverage and non-coverage decisions; facilitate multidisciplinary care rounds and quality improvement initiatives; manage patient transitions and ensure appropriate utilization of resources.
Seniority
Individual Contributor