RN Case Manager

The RN Care Manager plays a critical role in coordinating safe, effective, and patient-centered care across the continuum of hospital services. This position focuses on comprehensive assessment, care coordination, utilization review, and discharge planning to reduce readmissions, improve outcomes, and enhance patient and caregiver satisfaction. Working closely with interdisciplinary healthcare professionals, the RN Care Manager supports complex patient populations—particularly geriatric patients—by ensuring timely access to appropriate post-acute services and resources.

This role is ideal for experienced nurses who enjoy clinical problem-solving, collaboration, and making a measurable impact on patient outcomes and care efficiency.

Complete comprehensive initial patient assessments in accordance with Care Management policies

Perform multidisciplinary care coordination across intra-hospital and inter-hospital levels of care

Lead transitional care planning activities, including:

• Patient and caregiver education
• Coordination of post-acute and aftercare services
• Collaboration with commercial payers
• Evaluation of high-utilizer patient root causes

Communicate and collaborate relevant patient information with appropriate members of the healthcare team

Support departmental goals related to length-of-stay reduction, readmission prevention, denial reduction, and patient satisfaction improvement

Complete documentation in accordance with departmental standards

Participate in performance improvement initiatives as needed

Perform utilization review (UR) activities in alignment with departmental policy, including:

• Commercial payer reviews
• Admission clinical reviews
• Retroactive and self-audits
• Medical necessity variance analysis

Collaborate with healthcare professionals to evaluate care needs and ensure safe discharge planning for geriatric patients across inpatient, emergency department, and surgical outpatient settings

Perform additional related duties as assigned

Bachelor of Science in Nursing (BSN) required

Active Registered Nurse (RN) license in the state of practice

PRI Certification (must be obtained within three months of hire)

Strong computer proficiency

Screen Certification (strongly preferred)

Care Management certification (e.g., CCM, CMC, or equivalent)

Minimum of three (3) years of clinical experience in emergency, critical care, or medical-surgical nursing

Knowledge of healthcare finance, regulatory requirements, and payer systems

Familiarity with state, local, and federal healthcare programs

Experience using Milliman or Inter Qual medical necessity criteria

Strong two-way communication skills with the ability to clearly define expectations and actively listen

Effective delegation and team collaboration skills

Ability to remain composed under pressure and manage multiple priorities simultaneously

Ability to walk, stand, and sit for extended periods of time

Ability to carry necessary equipment (e.g., laptop or tablet) during rounds

Adequate manual dexterity, hand-eye coordination, and visual and auditory acuity

Ability to follow written and verbal instructions and meet regulatory requirements

Exposure to standard healthcare-related chemicals in accordance with safety guidelines

Ability to analyze complex, multidimensional problems and prioritize tasks effectively

• Adult (18–64 years)
• Geriatric (65+ years)
• Patients with complex medical, cultural, communication, developmental, or end-of-life care needs
• Patients under isolation precautions
• Bariatric patients with weight-related comorbidities

• Location:
  
  White Plains, New York
• Work Type:
  On-site
• Schedule:
  
  Full-time, day shift
• Monday–Friday, 9:00 a.m. – 5:00 p.m.
• Weekend rotation once per month (Saturday and Sunday)