We are seeking a Registered Nurse (RN) Case Manager to support inpatient, outpatient, and utilization management services within a care management department.

Key Responsibilities Include

• Providing care coordination, discharge planning, and safe patient transitions across all age groups.
• Participating in multidisciplinary rounds and collaborating with providers, therapists, pharmacists, and social workers.
• Supporting outpatient care through referral management, transition of care, and home health coordination to reduce readmissions.
• Conducting utilization reviews, ensuring medical necessity, and working with insurance payors for billing and denials.
  
  

Qualifications Include

• Graduate of an accredited nursing program with at least 1 year of relevant experience.
• Active RN license in the state of practice and CPR/BLS certification.
• Completion of required certifications and competencies, with preferred Bachelor's degree and bilingual skills (English/Spanish or other languages).
  
  

Skills Required

• Excellent communication, collaboration, and organizational skills.
• Proficiency in electronic medical records (Cerner/Oracle), Microsoft Office, and electronic referral systems.
• Ability to work in clinical and remote environments, with flexibility for on-call, weekend, and holiday coverage.
  
  

Additional Duties Include

• Supporting inpatient units and outpatient clinics, with some work performed in person and remotely.
• Attending multidisciplinary rounds and working closely with healthcare teams to ensure quality patient care.
  
  

Join a dynamic team committed to patient-centered care and care coordination excellence.