Nurse Case Manager - RN

Job Summary:

The Nurse Case Manager RN is responsible for evaluating prospective residents in hospitals, reviewing referrals, coordinating admissions, and ensuring appropriate care planning. This role involves collaborating with admissions, nursing, therapy, and insurance case managers to facilitate seamless transitions, maintain accurate documentation, and support reimbursement processes.

Duties And Responsibilities:

1. Referral and Admission Management (30%)
2. Care Coordination and Documentation (25%)
3. Insurance and Reimbursement Support (20%)
4. Interdisciplinary Collaboration and Education (10%)
5. Compliance and Training (10%)
6. Other Duties as Assigned (5%)

Qualifications:

• Education: Graduate of an accredited school of nursing.
• Licensure: Current RN license in the state of practice.
• Experience: Previous experience in long-term care, case management, or admissions preferred.
• Skills: Ability to function independently and make critical decisions. Strong interpersonal skills to work effectively with residents, families, and healthcare professionals. Knowledge of nursing and medical practices, long-term care regulations, and reimbursement policies. Proficiency in Microsoft Office (Excel, Word) and electronic health record (EHR) systems.

Physical Requirements:

• Reliable transportation for travel to hospitals and service areas.
• Flexibility to accommodate changing schedules and patient needs.
• Ability to sit, stand, and walk for extended periods.
• Ability to perform repetitive tasks and physical activities, such as bending, kneeling, and reaching.
• Ability to lift up to 10 pounds.
• Work is performed in a healthcare environment, with exposure to infectious diseases, bodily fluids, and potentially hazardous materials.