The RN Care Manager will oversee a daily caseload of patients on the inpatient units with a variety of care needs. Attend interdisciplinary rounds. Complete initial assessments. Facilitates the development of a plan of care in collaboration with the patient, family, caregiver and health care team. Communicate consistently with medical teams and patient regarding progress of care needs related to post discharge care needs, such as home health, inpatient rehab. Will interact with post acute care referral sources to establish a plan. Document and place orders for home health, DME, nutritional needs within EPIC EMR.