Registered Nurse RN - Case Manager

Job Summary

Responsible for providing comprehensive assessment, planning, implementation, and overall evaluation of individual patient needs. Collaborate with physicians, patient/family, nurses, utilization review, and other members of the healthcare team to ensure patient management aligns with patient needs and optimizes quality, clinical, and cost‑effective outcomes. Coordinate a team approach to achieve expected patient outcomes, including transitions to the next level of care. Manage length of stay, regulatory compliance, and participate in interdisciplinary rounds on the assigned unit.

Collaborate with community providers to coordinate post‑hospitalization care plans.

• Monitor all patients on assigned units to ensure appropriate use of resources and interventions while managing patient length of stay based on DRG/admitting diagnosis.
• Communicate with physicians, patients/families, and other disciplines about expected length of stay and progress toward discharge.
• Provide coordination and facilitation oversight of patient care to ensure interventions occur in proper sequence and processes occur timely.
• Identify and act upon potential delays in services; escalates unresolved delays to management for appropriate intervention.
• Assess, coordinate, and facilitate discharge planning to ensure post‑acute needs are arranged before discharge; reassess plan routinely.
• Provide patients/families with information regarding their plan of care, discharge, and any financial responsibility.
• Maintain knowledge of reimbursement methodologies and coverage guidelines for all levels of inpatient and outpatient care.
• Coordinate with utilization review nurse and other team members to ensure patients are in the correct status and level of care.
• Serve as liaison to families, physicians, nursing staff, and other disciplines to achieve optimal discharge outcomes.
• Actively support a customer‑service oriented environment and communicate directly with physicians, nursing staff, patients/families, and other disciplines to ensure collaborative practice.
• Provide appropriate hand‑off communication as patients transition between units.
• Maintain positive attitude and respond effectively to change, offering suggestions to improve workflow.
• Maintain detailed knowledge of community resources, governmental regulations, and third‑party payers.
• Adhere to all regulatory and DNV requirements and complete required paperwork.
• Work all scheduled shifts, including weekend rotation and remote coverage.

• Licensed to practice as an RN in Georgia.
• Associate degree from an accredited school of nursing.
• Three to five years of direct patient care and/or case management experience.
• Experience in financial and discharge planning.
• Demonstrated critical care, cardiac, medical, and/or surgical nursing aptitude.
• Working knowledge of state and federal regulations.
• Excellent observation, analytical thinking, problem‑solving, and self‑directed skills.
• Excellent oral and written communication skills.
• Strong interpersonal skills, professionalism, teamwork, and a positive approach.
• Ability to think outside the box and create innovative solutions.

• Case Management Certification (CCM) or American Case Management Certification (ACM).
• Bachelor’s degree.

Weight lifted up to 20 lbs; occasionally 0‑30% of time. Weight carried up to 20 lbs; occasionally 0‑30% of time. Vision moderate; occasionally 0‑30% of time. Knee, stoop, bend, stand, walk, push, pull occasionally 0‑30% of time. Intensity of work frequently 31‑65%. Reading, writing, reasoning, talking, keyboarding, and general job duties also required.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.