Care Manager ER Registered Nurse

Physicians Regional Healthcare System; Naples (FL); On-site; USD 65,000 - 90,000; Full time

Job summary

Physicians Regional Healthcare System is seeking a Care Manager – ER to collaborate with the emergency department team to assess admissions and determine appropriate status using evidence-based criteria such as MCG or InterQual.

The role supports efficient patient flow by guiding at-risk patients to community resources and coordinating transitions of care, including discharge planning for hospice or post-acute services.

Qualifications

• Knowledge of admission criteria and care level determination tools (MCG, InterQual)
• Strong clinical assessment and decision-making abilities
• Ability to coordinate with community resources and discharge planning
• Excellent communication with patients, families and interdisciplinary teams
• Strong organizational skills with attention to documentation and compliance

Responsibilities

• Assess patients in the ED for medical necessity of admission and determine correct status using established criteria.
• Identify patients suitable for alternative care settings and coordinate with community resources to avoid unnecessary admissions.
• Provide guidance to patients and families about care transitions, hospice services, and post-acute placement; obtain required documentation.
• Verify next of kin and emergency contact information; document accurately in patient records.
• Collaborate with ED clinicians, hospitalists, care managers and social services to support seamless transitions of care.
• Perform other duties as assigned and maintain regular attendance and compliance with policies.

Skills

MCG knowledge

InterQual knowledge

Clinical assessment

Care coordination

Communication

Organization

Education

BSN preferred

Job description

Job Summary

The Care Manager – ER collaborates with the emergency department team to assess potential admissions and determine appropriate status placement using evidence-based criteria such as MCG or third-party review tools. This role supports efficient patient flow by avoiding unnecessary admissions and guiding at-risk patients and families to appropriate community-based resources. The Care Manager – ED facilitates transitions of care, supports discharge planning, and ensures regulatory and documentation requirements are met for patients entering hospice or post-acute services.

Essential Functions

• Assesses patients in the emergency department for medical necessity of admission and ensures correct placement into inpatient, observation, or outpatient status using MCG or approved criteria.
• Identifies patients who may be appropriate for alternative care settings and works to avoid unnecessary admissions by coordinating with community resources.
• Provides timely guidance and education to patients and families regarding care transitions, including hospice services or post-acute facility placement, and secures patient choice documentation as required.
• Verifies next of kin contact information and emergency contact, and ensures accurate documentation on patient records.
• Collaborates with ED clinicians, hospitalists, care managers, and social services to support seamless transitions of care.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• Bachelor's Degree in Nursing (BSN) preferred
• 1-3 years of experience in an acute care or hospital setting required
• 1-2 years of experience in care management or utilization review preferred

Knowledge, Skills and Abilities

• Knowledge of admission criteria and care level determination tools such as MCG or InterQual.
• Strong clinical assessment and decision-making skills.
• Ability to effectively coordinate community-based services and discharge planning.
• Excellent communication and interpersonal skills for patient and interdisciplinary team interactions.
• Strong organizational skills with attention to detail and compliance documentation.

Licenses and Certifications

• RN - Registered Nurse - State Licensure and/or Compact State Licensure licensed in state of employment or compact state licensure required
• BLS - Basic Life Support preferred