RN Case Manager-PRN
Key Responsibilities
- Support the care coordination process by assessing patient needs and developing individualized care plans.
- Ensure patients are assigned the appropriate level of care, receive necessary services, and transition smoothly to post-discharge care settings.
- Perform accurate, timely, and effective discharge planning in collaboration with clinical teams.
- Communicate with third-party payers to verify coverage and authorization requirements.
- Educate patients and families regarding care plans, medications, and health management.
- Aid in the administration of education and prevention programs to promote health and wellness.
- Support hospital compliance with regulatory and payer guidelines, including Medicare, Medicaid, and commercial insurance.
- Affirm documentation and software systems such as Cerner, MCCM, SMS, and Windows applications.
Qualifications
- Associate's Degree in Nursing required. BSN preferred.
- Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.
- Certification in Case Management preferred.
- Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
- Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
- Ability to comprehend third party contractual arrangements is preferred.
- Understanding of the third party denial and appeal process is preferred.
- Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.
- 3-5 years of experience required.
- Requires strong clinical background in acute care.
Pay
The pay for this role is competitive and commensurate with experience.
Schedule
This role is available on a PRN/Supplemental basis, meaning availability may vary based on hospital needs.
Benefits
The benefits package includes comprehensive health insurance, retirement plans, and opportunities for professional development.
Skills
Strong communication skills, clinical expertise, and the ability to work effectively in a team environment are essential.
Benefits
The benefits package includes comprehensive health insurance, retirement plans, and opportunities for professional development.
Pay
The pay for this role is competitive and commensurate with experience.
Schedule
This role is available on a PRN/Supplemental basis, meaning availability may vary based on hospital needs.
Application Instructions
To apply, please visit our careers page and submit your resume and cover letter detailing your relevant experience and qualifications.