RN Nurse Case Manager II

Job Description

Networks Connect is seeking a RN Nurse Case Manager that will work in person. Are you a dedicated Registered Nurse (RN) Case Manager looking to make a difference in patient care? We are seeking an experienced RN Case Manager II to provide comprehensive case management services to patients and their families in an inpatient and post-anesthesia care unit (PACU) setting.

This role involves assessment, care planning, intervention, follow-up, and service coordination to ensure seamless patient transitions. The RN Case Manager will also engage in community outreach and contribute to administrative tasks as needed.

Join a team where nursing practice aligns with national and specialty standards, hospital policies, and healthcare regulations. This position requires accountability, autonomy, and collaboration in delivering high-quality care.

Qualifications

• Education: Master’s degree in a related field (Required).
• Experience: Minimum of 5 years of experience as an RN, with at least 3 years in a pediatric setting (Required).
• Licenses & Certifications:
  • Registered Nurse (RN) license – DC (Required).
  • Case Management Certification (Preferred).

Key Responsibilities

Professional Practice & Research

• Participate in Shared Leadership initiatives.
• Contribute to Magnet Recognition Program efforts.
• Utilize evidence-based best practices in nursing care.
• Engage in nursing performance improvement processes at the division or unit level.
• Support community health and wellness initiatives.

Patient Resource & Case Management Services

• Identify and communicate insurance denials, high-risk cases, and changes in patient care levels to minimize financial risks.
• Navigate internal and external systems to secure coverage and connect patients to necessary services.
• Ensure efficient care transitions by collaborating with the healthcare team.

Discharge Planning & Transitional Care

• Define discharge and care transition plans in collaboration with the healthcare team.
• Conduct patient and family assessments to identify potential barriers to discharge.
• Develop and implement care plans, making referrals as needed.
• Coordinate post-discharge services to achieve optimal patient outcomes.
• Provide clinical reviews to third-party payers using standardized criteria to validate authorizations.

Documentation & Compliance

• Maintain accurate and detailed documentation in compliance with departmental policies.
• Identify and implement process improvements for enhanced patient care, customer service, and reimbursement outcomes.

Performance Improvement & Safety

• Identify and address performance improvement (PI) opportunities.
• Promote cost-effective healthcare practices.
• Ensure a safe and collaborative work environment.
• Actively promotes patient and workplace safety through proactive measures.

Why Join Us?

• Collaborative & Supportive Work Environment
• Opportunities for Professional Growth & Development
• Competitive Compensation & Benefits
• Commitment to Community Health & Wellness

Apply Today!

If you are an experienced RN Case Manager looking to advance your career in a fast-paced, patient-centered environment, apply now to become part of a dedicated healthcare team!

Earnings

$90,000 -$130,000 salary

Category

Revenue Cycle