Registered Nurse Case Manager responsible for coordinating patient care activities, utilization management, discharge planning, and communication across multidisciplinary teams.
Compensation
Flat Rate of $69.32 Hourly
Responsibilities
Facilitates patient care progression across continuum
Identifies and resolves delays to discharge
Collaborates with medical staff to eliminate barriers
Communicates with patients and families about care plans
Utilizes InterQual criteria for admission and stay monitoring
Requirements
Bachelor's degree in nursing (BSN) or 1 year experience for non-BSN employees
Nice to have: R.N. with at least 2 years clinical experience in relevant specialty
Social Worker reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
Responsibilities
Collaborates with the care team for discharge planning and community linkage for patients and families with complex social, economic, and emotional needs.
Participates in care conferences and unit rounds. Keeps all members of the care team apprised of the current state and plan of care.
Develops positive relationships with co-workers, members of the care team, and community resources.
Collaborates with care team members to identify at risk populations and opportunities to improve care delivery and on-going support, thus increasing efficiencies and effectiveness.
Makes timely and appropriate referrals to ancillary support staff in order to facilitate progress toward a safe discharge.
Requirements
Licensed Social Worker (LSW)
Nice to have: Two years’ experience in an acute hospital setting
Nice to have: Experience in a level III nursery for maternal child area
Nice to have: Licensed Clinical Social Worker (LCSW)
Nice to have: ACSW (Academy of Certified Social Workers)
Utilizes clinical expertise to apply specialized case and utilization management methodologies to ensure medical appropriateness and coordinate care for high-risk financial, clinical, and social cases.
Responsibilities
Apply specialized case and utilization management methodologies
Coordinate care and patient flow
Identify high risk financial, clinical, and social cases
Negotiate reimbursement with payer sources
Requirements
Bachelor of Science degree in nursing
Nice to have: Regulatory requirements knowledge
Nice to have: Utilization Management certification
Supports the manager in the coordination of daily care management operations while serving as a clinical and operational expert for the team.
Compensation
Pay Range: $44.76 - $67.19/hr. (depends on years of experience)
Responsibilities
Coordinates daily case management operations, including patient assignments, workload balancing, staffing coverage, and workflow prioritization to support efficient patient care delivery.
Serves as the primary resource and escalation point for complex patient cases, care coordination challenges, and day-to-day operational issues.
Provides guidance, coaching, and real-time consultation to case management staff regarding assessment, care planning, transitions of care, resource utilization, and regulatory requirements.
Supports onboarding, orientation, competency development, and ongoing professional growth of case management team members through education, mentorship, and knowledge sharing.
Monitors case management workflows, documentation practices, and required regulatory activities to promote compliance, quality, consistency, and timely completion of work.
The Registered Nurse II PRN assesses, plans, directs, implements, and assists to provide quality patient care for assigned patients.
Responsibilities
Plans, assesses, directs, implements and provides quality patient care for assigned patients to include modifying nursing care, medication administration and discharge planning
Provides education directed towards individualized patient needs utilizing the nursing process in coordination with policies and procedures
Monitors changes in patient condition to include recording and reporting symptoms, assessing vital signs and intervening when appropriate
Performs complete data collection from patient presenting complaints and pertinent history
Collaborates with patients to identify treatment plan goals, and discharges patients as appropriate with a written discharge plan
We are seeking an experienced RN Case Manager to support the National Care Coordination Command Center. This role focuses on coordinating patient care after hospital discharge, utilization review, and discharge planning. This is a non-bedside nursing position, with all work performed on-site at the National Call Center in Georgia.
Responsibilities
Coordinate care for patients transitioning from hospital to the next level of care
Review all inpatient admissions within 24 hours and initiate discharge planning
Assess, develop, implement, and evaluate individualized care plans for members
Collaborate with physicians and multidisciplinary healthcare teams to ensure appropriate patient care
Coordinate with patients and families regarding care transitions and discharge needs
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