Role Overview: The Case Manager (Acute Care) optimizes clinical and financial systems to promote positive health outcomes. They coordinate care, conduct utilization reviews, and facilitate discharge planning and care transitions to ensure high-quality, cost-effective patient care.
Responsibilities:
- Ensure chart/EMR accuracy aligns with review and regulatory standards through collaboration with the Utilization Review RN.
- Assess and re-evaluate patients’ care plans promptly after admission.
- Communicate with attending physicians and refer to physician advisors when needed.
- Meet with patients and families within 48 hours of admission to evaluate needs and provide support.
- Facilitate safe transitions from acute to post-acute care to reduce readmissions.
Qualifications & Skills:
- RN license in the relevant state; BSN preferred, with a requirement to obtain within 5 years.
- At least two years of hospital experience preferred; relevant experience in home care or payer settings considered.
- Strong clinical judgment, collaboration, critical thinking, and problem-solving skills.
- Proficiency in computer use, data analysis, and effective communication.
- Ability to work independently with professional accountability and adaptability to change.