RN Inpatient Care Manager
Base pay range
$34.17/hr - $34.17/hr
Job Summary
The RN Inpatient Care Manager coordinates the care and services of selected member populations to facilitate a safe and timely transition to the next appropriate level of care. The role clinically assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual’s health needs. The manager partners with the healthcare team to ensure all aspects of the patient’s needs—clinical, psychosocial, and financial—are adequately addressed, thereby managing the patient’s timely progression of care and safe transition from acute care. The manager promotes effective utilization and monitors health‑care resources, collaborates with the interdisciplinary team to build a comprehensive case‑management plan, and achieves optimal clinical and resource utilization outcomes.
Essential Duties
Develops a comprehensive case‑management plan by reviewing clinical findings, diagnostic reports, and coordinating with physicians.
Refers high‑risk patients to social services using specific criteria.
Implements actions to prevent readmissions and evaluates causes of readmission to develop prevention strategies.
Develops and documents a discharge/transition plan through collaboration with the interdisciplinary team.
Monitors and escalates financial management issues, communicating payer or financial problems to the team.
Facilitates patient progression by monitoring length of stay, actively participating in care rounds, and proposing solutions to barriers.
Coordinates transitions of care, communicating with patients, families, physicians, and the utilization review nurse.
Maintains knowledge of federal, state, and regulatory rules including CMS, Medicare, and The Joint Commission.
Provides education and resources to patients, families, and the health‑care team on effective progression of care.
Identifies potential risk‑management or quality issues and works with the team to resolve or refer them through the chain of command.
Required Skills & Experience
Excellent communication, negotiation, and conflict‑resolution skills.
Data and computer skills.
Knowledge of relevant state regulatory standards related to case management.
Rapid‑cycle change or clinical performance improvement experience.
Prior clinical experience in care and management of hospitalized patients.
Skills & Experience
Experience in acute‑care case management (preferred).
Case‑management training from a professional organization (preferred).
Case Mgr Cert. preferred
In Pt Case Management 2 years exp.