Case Manager, RN - Case Management - Per Diem 8 Hour Days (Non-Exempt) (Union)
Core
RN Case Manager providing care coordination, utilization management, and discharge planning for patients to ensure cost-effective, quality healthcare outcomes.
Role type
Registered Nurse (RN) Case Manager
Builds
Care coordination plans, discharge plans, and utilization review assessments for patient populations
Domain
Healthcare / Hospital Case Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Clinical assessment, care coordination, discharge planning, utilization management, interdisciplinary collaboration, data analysis, patient advocacy, resource management, regulatory compliance
Preferred skills
Bachelor's degree in Nursing, prior case management or utilization review experience
Technologies
InterQual, Work list, M drive, TAR systems
Responsibilities
Assess physical and biopsychosocial needs of patients; develop and document plans of care; initiate discharge planning within 24 hours; perform InterQual assessments; coordinate post-hospital care and transfers; participate in interdisciplinary meetings and physician rounds; manage caseload of 18-20 patients; educate healthcare team on reimbursement and observation status; handle appeals and payer communications.
Seniority
Mid-level, hands-on IC
