Case Management Nurse

HeartCentrix Solutions; United States; On-site; USD 85,000 - 105,000; Full time

Job summary

HeartCentrix Solutions seeks a Registered Nurse Case Manager to perform comprehensive assessments of high-risk members and coordinate individualized care plans with primary care providers. The role focuses on cost-efficient care levels, care transitions, and advocating for positive patient outcomes.

The ideal candidate will have RN licensure, case management certification, and experience with OASIS, wound care, IV and INR procedures, enabling sound clinical decisions and strong documentation.

Qualifications

• Associate's or Bachelor's Degree in Nursing or related field.
• Current, unrestricted CO Registered Nurse license.
• Case Management certification.
• OASIS knowledge.
• Wound care experience.
• IV experience.
• INR experience.
• Ability to analyze complex medical information and make sound clinical decisions.

Responsibilities

• Perform comprehensive assessments of high-risk members.
• Collaborate with primary care providers to implement individualized, comprehensive care plans with targeted interventions.
• Identify and continuously reassess appropriate, cost-efficient levels of care.
• Coordinate non-medical support (such as housing and transportation) to support treatment plan compliance.
• Coordinate care transitions as needed.
• Collaborate with physicians, social workers, discharge planners, and claims professionals to transition patients to appropriate levels of care.
• Engage specialty resources as needed to achieve optimal outcomes.
• Maintain detailed records of clinical, functional, and fiscal outcomes.
• Identify opportunities for health promotion and illness prevention.
• Proactively prevent adverse patient occurrences and intervene quickly to minimize poor outcomes when prevention isn't possible.
• Act as a patient advocate, protecting privacy and confidentiality.

Skills

Care coordination

Clinical decision making

Documentation accuracy

Patient advocacy

Stakeholder communication

Education

Nursing degree (ADN/BSN)

Tools

OASIS knowledge

Job description

We have multiple onsite positions throughout the US.

Position Overview

We are seeking a Registered Nurse Case Manager to perform comprehensive assessments of high-risk members and coordinate individualized care plans in collaboration with primary care providers. This role focuses on ensuring appropriate, cost-efficient levels of care, supporting care transitions, and advocating for positive patient outcomes.

Key Responsibilities

• Perform comprehensive assessments of high-risk members
• Collaborate with primary care providers to implement individualized, comprehensive care plans with targeted interventions
• Identify and continuously reassess appropriate, cost-efficient levels of care
• Coordinate non-medical support (such as housing and transportation) to support treatment plan compliance
• Coordinate care transitions as needed
• Collaborate with physicians, social workers, discharge planners, and claims professionals to transition patients to appropriate levels of care
• Engage specialty resources as needed to achieve optimal outcomes
• Maintain detailed records of clinical, functional, and fiscal outcomes
• Identify opportunities for health promotion and illness prevention
• Proactively prevent adverse patient occurrences and intervene quickly to minimize poor outcomes when prevention isn't possible
• Act as a patient advocate, protecting privacy and confidentiality

Required Qualifications

• Associate's or Bachelor's Degree in Nursing or related field
• Current, unrestricted CO Registered Nurse license
• Case Management certification
• OASIS knowledge
• Wound care experience
• IV experience
• INR experience
• Ability to analyze complex medical information and make sound clinical decisions

Ideal Candidate

The ideal candidate is an experienced RN who is skilled at coordinating complex care across multiple stakeholders, thrives in a patient-advocacy role, and is comfortable balancing clinical judgment with cost-conscious care planning. They are organized, detail-oriented in documentation, and proactive in identifying and addressing risks before they become adverse outcomes.