Posted 06/10/2025
*CA
The Nurse Case Manager collaborates, facilitates, and negotiates the delivery of individualized and medically necessary care to specific patient groups. Coordinates health management through professional nursing care, rehab services, respiratory services, patient/family education, and utilization of community resources to ensure the highest quality of care and cost-effective outcomes. Facilitates the interdisciplinary process of assessing, planning, implementing, and evaluating the patient's healthcare needs following the current phase of illness.
Requirements
Registered Nurse - NH State or Compact State
BSN Preferred
1-3 years experience
Acute setting, sub-acute, or SNF experience
Major Responsibilities
Assesses or prescreens all patients for Case Management services. Referrals are received from physician orders, nursing orders, and multidisciplinary rounds.
Develops needs and prioritizes with input from all parties to organize a plan that will provide maximal outcomes.
Serves as a liaison among the patient, family members, physicians, nurses, social workers, UR nurses, insurance representatives, and community resources to individualize patient care and outcomes.
Advocates for services and funding necessary to meet established outcomes and maintains a working knowledge of payer requirements.
Evaluates individualized patient outcomes and reassesses and adjusts plans to ensure quality and cost-effective outcomes are met.
Works in close collaboration with Social Work; reviews cases with social work team members to establish and review the care plan.
Collaborates with Core Care Coordinators to manage acute issues related to existing care plans, barriers, and ongoing needs.
ED Only : Participates in quality improvement projects aimed at improving patient population outcomes and associated processes across the EHR system.