RN - Case Manager

Location: Methodist Hospital
Shift: Full-Time Days  

Position: RN - Case Manager

 

Plans and coordinates care for patients from pre-admission through post-discharge by working collaboratively with the multidisciplinary team. Ensures that patients are assigned the appropriate level of care, receive the appropriate services, and are transitioned to the appropriate post-discharge level of care. Performs accurate, timely, and effective discharge planning for patients. Works with third-party payers to ensure coverage. Administers education and prevention programs.

Position Overview

The RN-Case Manager plays a critical role in ensuring seamless patient transitions across various care settings. This position involves assessment, coordination, and communication with patients, families, providers, and payers to optimize outcomes and resource utilization. The nurse collaborates closely with the multidisciplinary team to develop individualized discharge plans, manage insurance coverage, and facilitate patient education and safety.

Key Responsibilities:

• Plan and coordinate patient care from pre-admission through post-discharge, ensuring appropriate levels of care and services.
• Perform accurate and timely discharge planning, including documentation and communication.
• Collaborate with the multidisciplinary team to develop comprehensive care plans.
• Work with third-party payers to verify coverage and facilitate authorization for services.
• Educate patients and families on post-discharge care, safety, and prevention.
• Assist with third-party denials, appeals, and understanding contractual arrangements.
• Ensure compliance with Medicare, Medicaid, insurance, and regulatory guidelines.
• Utilize various software applications including Windows, Cerner, MCCM, and SMS for documentation and communication.

Qualifications & Requirements:

• Education:
  • Associate's Degree in Nursing required.
  • New ASN RNs hired after January 1, 2013, will be required to complete their BSN within 5 years of hire.
• Licensure:
  • Active RN license in Indiana or Nurse Licensure Compact (NLC).
• Certifications:
  • Case Management certification preferred.
• Experience:
  • 3-5 years of clinical experience in acute care required.
• Knowledge & Skills:
  • Knowledge of InterQual Acute Level of Care Criteria and federal coverage guidelines is preferred.
  • Familiarity with Medicare/Medicaid, insurance policies, and regulatory requirements is preferred.
  • Ability to understand third-party contractual arrangements and the denial/appeal process is a plus.
  • Proficiency with Windows, Cerner, MCCM, SMS, and other relevant software applications.
  • Strong clinical background in acute care with excellent assessment and communication skills.

Why IU Health University Hospital?

As part of Indiana’s largest and most comprehensive healthcare system, we offer:  

• Competitive salary and comprehensive benefits
• Opportunities for professional development and growth
• A collaborative, innovative environment dedicated to excellence

If you'd like to learn more about our benefits, please visit: IU Health Benefits

Join IU Health!

Be part of Indiana’s leading healthcare system dedicated to delivering exceptional patient care, effective care coordination, and innovative discharge planning. We offer professional development, a collaborative environment, and meaningful work that makes a difference.

Ready to lead seamless patient transitions? Apply today to become an RN - Case Manager at IU Health Methodist Hospital!  

 

• Indiana University Health has nearly 40,000 team members, including more than 3,600 physicians and 1,200 advanced practice providers, and we’re home to the largest nursing network in Indiana with more than 9,000 nursing team members at over 800 sites of care.
• IU Health is ranked No. 1 in Indiana by U.S. News & World Report, Riley Children's Health is ranked among the top children's hospitals in the country by U.S. News & World Report.
• A unique partnership with the Indiana University School of Medicine – one of the nation’s largest medical schools – gives patients access to groundbreaking research and innovative treatments, and it offers team members access to the latest science and the very best training – advancing healthcare for all.
• With 15 hospitals, including seven with Magnet designation and eight with Pathways to Excellence designation, our team members are leading the way through excellence.
• At Indiana University Health, your personal and professional growth is a top priority. You will have access to many diverse opportunities to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development, promotion opportunities and cross training development.
• Indiana University Health is invested in the lives of Hoosiers, leading the transformation of healthcare to make Indiana one of the nation’s healthiest states.