RN Complex Case Management - Hybrid in Las Vegas, NV

Primary Responsibilities

• Manage a caseload of 70+ patients, prioritizing care needs using solid clinical judgment and critical thinking
• Perform post-hospital discharge follow-ups to ensure safe transitions of care and reduce avoidable readmissions
• Provide patient education on diagnoses, medications, and treatment plans to improve self-management and adherence
• Carefully coordinate care across primary care, specialty providers, and community resources to ensure continuity and quality outcomes
• Apply case management standards of practice to effectively manage MA populations
• Serve as a patient advocate, providing clinical insight and recommendations to the interdisciplinary care team
• Conduct assessments and develop in collaboration with patients, families, and providers
• Identify and close gaps in care across transitions, breaking down silos and promoting efficient healthcare delivery
• Partner with providers to implement strategies that prevent readmissions and improve outcomes
• Maintain solid knowledge of case management practices, benefits, and community resources
• Support chronic disease management and preventative care initiatives with accurate documentation
• Follow established protocols related to medication management, preventive services, and disease management

Required Qualifications

• A High School diploma or equivalent
• An active, unrestricted Registered Nurse (RN) license in the State of Nevada
• 3+ years of direct patient care nursing experience, including discharge planning or care coordination
• 2+ years of dedicated Case Management experience
• Demonstrated solid critical thinking and clinical decision-making skills in a case management setting
• Proven experience managing complex, high-risk patient populations and high-volume caseloads
• Proven knowledge of utilization management and health plan benefit structures
• Proven excellent verbal and written communication skills
• Proven solid organizational, prioritization, and care coordination skills
• Proficiency with MS Office and care management systems
• A valid Nevada driver's license with access to reliable transportation and active auto insurance

Preferred Qualifications

• A Bachelor's degree in Nursing or related healthcare field (or in progress)
• Certified Case Manager (CCM) certification