RN Case Manager – Critical Access Hospital

Monday–Friday Schedule | Acute Care Hospital | Make a Meaningful Impact Every Day

Are you an experienced Registered Nurse who thrives on coordinating exceptional patient care while ensuring safe, efficient transitions from hospital to home? We're seeking a compassionate and detail-oriented RN Case Manager to join a collaborative healthcare team dedicated to delivering outstanding patient outcomes. This opportunity is based on the responsibilities outlined in the provided job description.

In this role, you'll serve as a vital link between patients, providers, families, and community resources—helping ensure patients receive the right care, at the right time, in the most appropriate setting.

• Coordinate patient care throughout the continuum, from admission through discharge
• Develop individualized discharge plans that promote safe, timely transitions
• Conduct utilization reviews and medical necessity assessments using established clinical criteria
• Collaborate with physicians, nursing leadership, interdisciplinary teams, and payers to support quality care and appropriate reimbursement
• Coordinate post-acute services including home health, skilled nursing, hospice, DME, and other community resources
• Monitor denials, appeals, length of stay, and readmissions while identifying opportunities for process improvement
• Advocate for patients and families while ensuring compliance with CMS, payer, and regulatory requirements
• Participate in interdisciplinary rounds and quality improvement initiatives

• Current Registered Nurse (RN) license
• 2+ years of clinical nursing experience
• Experience in Case Management, Utilization Review, Care Coordination, or Discharge Planning preferred
• CCM or ACM certification is a plus
• Strong clinical judgment, communication, and critical thinking skills
• Knowledge of payer requirements, medical necessity criteria, and care coordination best practices
• Ability to balance exceptional patient care with operational and financial stewardship

• Monday–Friday schedule with work‑life balance
• Collaborative interdisciplinary team environment
• Opportunity to make a direct impact on patient outcomes and care quality
• Leadership that values clinical expertise and professional autonomy
• Meaningful role with opportunities to contribute to quality improvement and organizational success

JOB : 179180#post