RN Case Manager - Monroe

Job Overview

Responsible for multidisciplinary communication and facilitation of care throughout a patient’s hospitalization. The role reviews patient hospitalizations, recommends the appropriate level of care according to medically necessary criteria, confirms clear documentation, and acts as a liaison among patients, caregivers, multidisciplinary team members, and post‑acute or third‑party payers.

• Performs pre‑admission, admission, and continued stay reviews per CMS and payer guidelines.
• Collaborates with the care team to develop and implement discharge plans tailored to individual patient needs.
• Communicates with ED physicians, hospitalists, attending physicians, and physician advisors.
• Oversees functional and financial outcomes, coordinating and implementing discharge plans during acute‑care hospitalization.
• Makes recommendations regarding alternative care options as appropriate.
• Maintains knowledge of utilization review and discharge planning regulations, ensuring compliance with all relevant laws and standards.
• Supports service excellence, teamwork, and integrity, maintaining licensure standards and pursuing professional development.

• Education Required: Graduate of an accredited school of nursing.
• Preferred: Bachelor’s degree in nursing.
• Work Experience: None required. Preferred: 3 years of hospital‑based experience in discharge planning, case management, or utilization review.
• Certifications: Current registered nurse license in state of practice;
  Basic Life Support (BLS) from the American Heart Association.
• Preferred
  
  Certifications:
  
  Case Management (CCM) or Accredited Case Manager (ACM).
• Knowledge, Skills, and Abilities: Proficiency with computers, software, and web‑based applications; effective verbal and written communication; strong interpersonal skills; ability to work a flexible schedule including 24/7, weekends, holidays, and on‑call availability.

Physical demands include occasional lifting of 20 to 50 pounds and frequent lifting of 10 to 25 pounds. The role involves moving objects and being in patient care areas where exposure to blood, body fluids, and communicable diseases is possible. Occupational risks for hazardous medications, waste, and environmental threats exist.

The employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and other compliance‑related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.