Case Manager, Registered Nurse

Lake Cumberland Regional Hospital; Kentucky; On-site; USD 65,000 - 90,000; Full time

Job summary

Lake Cumberland Regional Hospital seeks a Case Manager, Registered Nurse to coordinate patient care across the continuum in our 295-bed acute care facility. The RN Case Manager conducts assessments, develops discharge plans, and facilitates transitions of care, collaborating with physicians, nurses, social workers, and community providers.

The role includes utilization review, authorization coordination, patient and family education, and advocating for quality, cost-effective care while ensuring

Qualifications

• RN with case management responsibilities
• Experience in acute care settings preferred
• Knowledge of discharge planning processes
• Understanding of utilization review and payer coordination
• Strong care coordination and collaboration skills
• Proficiency with electronic health records (EHR)
• Ability to educate patients and families about care plans
• Commitment to high-quality, cost-effective care

Responsibilities

• Conduct comprehensive patient assessments and identify post-acute care needs
• Develop, implement, and update individualized discharge and transition-of-care plans
• Coordinate with physicians, nursing staff, therapy, and social services to optimize care
• Perform utilization review and secure authorizations with payers as needed
• Educate patients and families on care plans, resources, and community services
• Advocate for patients to ensure quality, safe, and cost-effective care
• Collaborate with community agencies, skilled nursing, and home health providers
• Maintain accurate, timely case management and utilization documentation
• Ensure compliance with hospital policies, regulatory standards, and payer requirements
• Participate in performance improvement and case management program development

Skills

Acute care nursing

Clinical assessment

Discharge planning

Utilization review

Care coordination

Electronic health records

Interdisciplinary collaboration

Knowledge of payer regulations

Patient and family education

Documentation and reporting

Job description

Lake Cumberland Regional Hospital seeks a Case Manager, Registered Nurse to coordinate patient care across the continuum in our 295-bed acute care facility. The RN Case Manager conducts assessments, develops and updates discharge plans, facilitates transitions of care, and collaborates with physicians, nurses, social workers, and community providers. Responsibilities include utilization review, authorization coordination, patient and family education, and advocating for quality, cost-effective care. This role supports a patient-centered, community-focused environment while ensuring regulatory compliance, accurate documentation, and continuous improvement in clinical outcomes and patient experience.

Responsibilities

• Conduct comprehensive patient assessments and identify post-acute care needs
• Develop, implement, and update individualized discharge and transition-of-care plans
• Coordinate with physicians, nursing staff, therapy, and social services to optimize care
• Perform utilization review and secure authorizations with payers as needed
• Educate patients and families on care plans, resources, and community services
• Advocate for patients to ensure quality, safe, and cost-effective care
• Collaborate with community agencies, skilled nursing, and home health providers
• Maintain accurate, timely case management and utilization documentation
• Ensure compliance with hospital policies, regulatory standards, and payer requirements
• Participate in performance improvement and case management program development

Required Skills

• Acute care nursing
• Clinical assessment
• Discharge planning
• Utilization review
• Care coordination
• Electronic health records (EHR)
• Interdisciplinary collaboration
• Knowledge of payer regulations
• Patient and family education
• Documentation and reporting