Case Manager Registered Nurse

Prime Healthcare; Riverdale (GA); On-site; USD 55,000 - 83,000; Full time

Job summary

Southern Regional Medical Center in Riverdale, GA is seeking an experienced RN Case Manager for per diem, 8-hour day shifts. You will oversee and coordinate patient care from admission through discharge, collaborating with physicians, nurses, social workers, and others to ensure quality, cost-effective outcomes.

Responsibilities include assessment, care coordination, discharge planning, utilization review, and patient/family education to navigate insurance and healthcare systems.

Qualifications

• Active RN license and state authorization to practice.
• Minimum 5 years post-graduation nursing experience.
• At least 1 year in case management or discharge planning.
• CCM certification or CCM within 1 year preferred.
• Knowledge of Milliman and InterQual Criteria preferred.

Responsibilities

• Patient assessment of medical, psychosocial, and discharge needs.
• Develop and implement individualized care plans with the health team.
• Coordinate safe discharge planning to rehab, home health, or LTC.
• Monitor resources to ensure appropriate care and avoid unnecessary stays.
• Educate patients and families on care plans and post-discharge steps.
• Advocate for patient needs and preferences throughout care.

Skills

Case management

Discharge planning

Care coordination

Utilization review

Patient education

Education

Registered Nurse license

5+ years nursing experience

CCM certification (preferred)

Tools

Milliman Criteria

InterQual Criteria

Basic computer skills

Job description

Overview

Shifts Available: PRN/Days

Employment Type:Per-Diem (PRN Shifts)

Hours: 8 hour day shifts

Location: Southern Regional Medical Center– Riverdale, GA

We are seekinganRNCase Manager,also referred to as a Registered NurseCase Manageror RNClinical Case Manager.AnRN Case Manager willoversee and coordinate patient care from admission through discharge to ensure quality, cost-effective outcomes. They assess patients’ needs, develop care plans, and collaborate with physicians, nurses, social workers, and other providers to manage care transitions. RN Case Managers alsoconductdischarge planning,utilizationreview, andhelpingpatients navigate insurance and healthcare systems.This position is on a per diem basis, meaning PD/PRN as needed.

Responsibilities

• Patient Assessment:evaluate patients’ medical, psychosocial, and discharge needs upon admission and throughout their stay

• Care Coordination:develop and implement individualized care plans in collaboration with the healthcare team to ensure effective treatment andtimelyinterventions

• Discharge Planning:coordinate safe andappropriate dischargeplans, including referrals to rehab, home health, or long-term care facilities

• UtilizationReview:monitorthe use of hospital resources and services to ensureappropriate careand avoid unnecessarytreatmentsor extended stays

• Patient and Family Education:help patients and families understand care plans, post-discharge instructions, and available resources

• Advocacy:advocate for patient needs and preferences, ensuring care is aligned with their goals and values

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required Qualifications:

1. Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license2. At least one year experience in case management, discharge planning or nursing management3. Experience and knowledge in basic to intermediate computer skills.Preferred Qualifications:

4. Five years of acute care nursing experience. preferred5. CCM or obtained within 1year6. Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate, preferred

Employment Status

Per Diem

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights:https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf