Registered Nurse Case Manager

About This Role

Oversee the clinical plan of care for patients, ensuring adherence to evidence-based practice and regulatory requirements. This role integrates care coordination, utilization management, and discharge planning to drive exceptional patient outcomes.

Responsibilities

• Oversee the clinical plan of care to conform to evidence-based practice and regulatory requirements
• Integrate care coordination, utilization management, and discharge planning
• Perform medical necessity screening
• Facilitate multi-disciplinary patient care conferences
• Manage concurrent disputes and make appropriate referrals to other departments
• Communicate with patients and their families about the plan of care
• Collaborate with physicians, office staff, and ancillary departments
• Participate in weekly Complex Case Review
• Arrange for post-discharge patient education
• Maintain accuracy of patient demographic and insurance information

Requirements

• 5 years CM experience in an acute care setting; planning and executing post acute care discharges
• Proficient in care coordination in an acute care setting
• Knowledgeable of available resources for post acute discharge
• Demonstrated ability to effectively utilize Allscripts case management software
• Strong understanding of medical terminology, procedures, and documentation practices specific to neonatal care
• Excellent communication skills, both written and verbal
• Proven track record of conducting thorough assessments, developing care plans, and ensuring appropriate utilization of resources for neonatal patients
• Ability to provide and manage multiple tasks efficiently in a fast-paced environment
• Detail-oriented with a commitment to accuracy and compliance with regulatory standards
• Experience collaborating with insurance providers and external healthcare agencies
• Current California RN licensure

Qualifications

• 5 years CM experience in an acute care setting; planning and executing post acute care discharges

Nice to Have

• B.S.N.

Skills

* Required skills

Benefits