Nurse Case Manager, HCT (RN)
Core
Advocate for patients and families navigating external providers and healthcare systems to ensure safe, timely discharge to the lowest level of care.
Role type
Acute Care Nurse Case Manager (RN)
Builds
Effective care plans and longitudinal care coordination across the continuum of care
Domain
Healthcare / Acute and Post-Acute Care
Deliverable
client delivery
Required skills
Utilization review, care plan development, social assessment, discharge planning, stakeholder coordination, SDoH screening, clinical documentation
Preferred skills
Bilingual communication, compact RN license, Certified Case Manager certification
Technologies
Internal charting system, hospitals EMR system, Microsoft Office Suite
Responsibilities
Conduct hospital bedside discussions to explain care management programs; Identify barriers for safe discharge and manage safety risks; Coordinate transitions to SNF, LTC, or home; Perform SDoH screening and arrange follow-up PCP appointments; Document discharge dates and update patient problem lists.
Seniority
Mid-level, hands-on IC