RN Case Manager - Case Management - Per Diem 8 Hour Days (Non-Exempt) (Union)
Core
Provides care coordination services, evaluates options to meet individual health care needs, and promotes cost-effective, quality outcomes by integrating utilization management, quality management, discharge planning, and post-hospital care coordination.
Role type
RN Case Manager (Clinical Care Coordination & Utilization Management)
Builds
Safe discharge plans and coordinated post-acute care pathways for patient populations.
Domain
Healthcare / Hospital Case Management
Required skills
Clinical assessment, discharge planning, interdisciplinary collaboration, data analysis, resource management, patient advocacy, regulatory compliance (Medicare/InterQual), care coordination
Preferred skills
Bachelor's degree in Nursing, advanced clinical knowledge
Technologies
Electronic Health Records (EHR), Work list, M drive, Authorization log
Responsibilities
Assess physical and biopsychosocial needs of patients; develop and document plans of care; initiate discharge planning within 24 hours; perform InterQual assessments; coordinate with physicians, social workers, and post-acute services; manage caseload of 18-20 patients; participate in quality improvement processes; educate healthcare team on reimbursement and observation status.
Seniority
Mid-level, hands-on IC