RN Case Manager-PRN

Job Title: RN Case Manager

Location: Kenosha and Mount Pleasant
Employment Type: PRN

Position Summary

The RN Case Manager plays a critical role in coordinating patient care, ensuring smooth transitions, and optimizing outcomes. This position involves conducting comprehensive assessments, developing individualized care plans, and collaborating with patients, families, and multidisciplinary teams to achieve patient-centered goals.

Major Responsibilities

• Conduct complete assessments and establish appropriate care plans within required timeframes.
• Collaborate and negotiate effectively with patients, families, and healthcare teams to support discharge planning and care transitions.
• Utilize patient/family strengths in problem-solving and involve them in decision-making from admission through discharge.
• Provide continuity of care and discharge planning services compliant with regulatory standards, ensuring timely communication and coordination.
• Manage complex case needs, including health care, finances, housing, family dynamics, and illness adjustment, using community resources effectively.
• Initiate internal and external referrals to support timely progression of care and transitions.
• Document discharge planning interventions and utilization review activities accurately and promptly.
• Perform concurrent and retrospective reviews based on established criteria and department standards.
• Communicate effectively with healthcare teams and collaborate with Social Work and support staff to implement safe care plans.
• Serve as an active member of multidisciplinary teams to identify and resolve barriers to discharge and expedite care delivery.
• Collaborate with managers, physicians, and advisory groups to ensure best practices and compliance with regulatory guidelines.
• Maintain knowledge of healthcare regulations, reimbursement issues, and community resources.
• Complete utilization management activities, including payer updates, denial coordination, and CMS regulatory notices.
• Develop and maintain productive relationships with community agencies and internal teams to meet patient/family needs.
• Serve as an educator and resource for staff regarding admission status, utilization management, care coordination, and regulatory requirements.

Qualifications

• License/Certification: Registered Nurse (RN) license in the state of practice.
• Education: Bachelor’s Degree in Nursing (BSN) required.
• Experience: Minimum of 2 years of clinical nursing experience.
• Demonstrated knowledge and skills to provide age-appropriate care across the lifespan.
• Strong communication, collaboration, and problem-solving skills.

Why Join Us?

• Opportunity to make a meaningful impact on patient care and outcomes.
• Collaborative and supportive work environment.
• Comprehensive benefits package and professional development opportunities.