RN Case :Manager

Job Title: Case Manager (RN)

Job Summary: Coordinates and manages the complete cycle of patient care, from admission through discharge.

This role serves as the primary point of contact for residents, families, and a multidisciplinary team to ensure timely, appropriate, and cost-effective care.

The Case Manager advocates for residents' needs, educates families on treatment plans, and adjusts care based on changing conditions.

Essential Duties and Responsibilities:


* Develop, implement, and evaluate individualized plans of care for residents.


* Serve as a central communicator among residents, families, clinical staff, and third-party payers.


* Answer resident and family questions, ensuring they feel secure and informed about care, treatment, and progress.


* Monitor and adjust resident statuses and care plans based on changing needs and conditions.


* Oversee all admission and discharge activities, coordinating referrals to and from the facility.


* Organize and prioritize a daily caseload, managing new, current, and discharging residents.


* Complete timely and accurate documentation as required.


* Conduct utilization review activities to ensure appropriate, timely, and cost-effective care.


* Collaborate with financial services and third-party payers to coordinate care.

Qualifications:


* Validr RN license in the state of employment.


* A minimum of two (2) years of clinical nursing experience is preferred.


* Knowledge of Medicare, Medi-Cal, and Medicaid programs and benefits.


* Competence with PCC Knowledge is preferred.


* Certification as a Case Manager (CCM) is a plus.