Jobs · Healthcare · Tennessee

Registered Nurse (RN) - Hospital Care Manager, PRN, Days

Proforma Health · Maryville, TN · 1 wk ago
On-siteHealthcareFull-time
Role Overview: This position is a care management professional responsible for patient engagement, care transition, and ensuring care plan alignment. Key Responsibilities Collaborate with physicians and multidisciplinary teams to deliver efficient, quality, and cost-effective care.Coordinate post-acute care plans, address social determinants of health, and facilitate patient resource access.Identify and resolve system barriers affecting diagnosis and treatment, while driving performance improvements.Assess psychosocial risks and maintain expert knowledge of clinical outcomes and regulatory standards.Ensure appropriate care levels, medical necessity, and timely care plan implementation in compliance with hospital policies.Navigate regulatory, compliance, and insurance requirements, liaising with payors and advocating for patient rights and autonomy.Serve as a resource for patients and families regarding their rights, responsibilities, and care options. Qualifications & Skills Bachelor’s degree in Nursing or equivalent with relevant experience; RN licensure in South Carolina required.Minimum three years of acute care nursing; case management experience preferred.Certifications such as ACM or CCM are desirable.Knowledge of medical necessity criteria and healthcare regulations preferred. Additional Details: This is a non-management role reporting to a supervisor, with a focus on patient-centered care and system navigation. The role requires ongoing education and compliance with relevant licensing and certification standards.

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