Case Management RN: Care Transitions & Payer Liaison

Owensboro Health; Owensboro (KY); On-site; USD 70,000 - 90,000; Full time

Job summary

Owensboro Health is seeking an RN Case Manager (0.9 FTE) to facilitate cost-effective, high-quality patient outcomes by determining appropriate levels of care and guiding transitions. You will work with physicians, payers, and the care team to ensure timely and compliant patient discharge planning.

Responsibilities include chart reviews for medical necessity, collaboration with interdisciplinary teams, and educating patients and families about case management processes.

Qualifications

• Bachelor’s degree or higher in Nursing is required upon hire.
• RN license to practice nursing in Kentucky is required upon hire.
• Eligible to practice nursing in the State of Kentucky.

Responsibilities

• Assess chart and patient condition to determine appropriate level of care and transitions.
• Conduct initial and concurrent reviews of documentation for medical necessity.
• Provide clinical information to payers as requested within required timeframes.
• Collaborate with physicians and care teams on regulatory requirements and discharge planning.
• Educate patients and families about case management processes and resources.
• Train new case managers, students, and interns as needed.

Skills

Critical thinking

Decisive judgment

Work under pressure

Education

Bachelor’s degree or higher in Nursing

Job description

Owensboro Health is seeking an RN Case Manager (0.9 FTE) to facilitate cost-effective, high-quality patient outcomes by determining appropriate levels of care and guiding transitions. You will work with physicians, payers, and the care team to ensure timely and compliant patient discharge planning.

Responsibilities include chart reviews for medical necessity, collaboration with interdisciplinary teams, and educating patients and families about case management processes.