Case Manager - RN

St. Francis-Emory Healthcare; Columbus (GA); On-site; USD 65,000 - 85,000; Full time

Job summary

St. Francis–Emory Healthcare in Columbus, GA seeks an RN–Case Manager to assess and coordinate patient care across the continuum. You will plan discharges, arrange post-discharge services, and collaborate with a multidisciplinary team to ensure high-quality outcomes.

Responsibilities include documenting in the EMR, communicating with insurers for authorization, and supporting improvement initiatives while maintaining patient advocacy and compliance with CMS guidelines.

Qualifications

• Associate Degree in Nursing is required.
• Current and valid RN license in state of practice or Compact State.
• BLS certification required within facility policy.

Responsibilities

• Assess, plan, coordinate, and monitor patient care and resources.
• Coordinate discharge planning and post-discharge services.
• Collaborate with physicians, patients, and families to ensure quality care and safe transitions.
• Communicate with payers for authorization and continued stay approvals.
• Document activities and education in the EMR.
• Support performance improvement and data collection efforts.
• Conduct 48-hour post-discharge follow-up if applicable.
• Stay current with Medicare/Medicaid rules and payer requirements.

Skills

Case Management

Discharge Planning

Payer Authorization

EMR Proficiency

Interpersonal Communication

Education

Associate Degree in Nursing

BSN preferred

Tools

EMR systems

Job description

Description

Join St. Francis–Emory Healthcare, a 376-bed community-connected hospital in Columbus, GA, that blends cutting-edge care with hometown purpose. As part of the ScionHealth network, St. Francis has been recognized and awarded multiple high-performing honors by U.S. News & World Report, and received multiple disease-specific certifications from the Joint Commission, and was a rated Top Large Hospital in Georgia. St. Francis also delivers advanced heart, orthopedic, and women’s care services. At St. Francis, you will experience a culture of excellence where your work directly shapes the health of our community.

Job Summary

The RN–Case Manager is responsible for assessing, planning, coordinating, and monitoring the healthcare services and resources necessary to meet the individual needs of patients. This role ensures effective case management processes that promote optimal patient outcomes, quality of care, regulatory compliance, and cost efficiency across the continuum of care.

Essential Functions

• Reviews clinical documentation and coordinates care across departments to ensure medically necessary services are provided in a timely and cost-effective manner
• Performs discharge planning by identifying patient needs and arranging post-discharge services including home health, medical equipment, and rehabilitation
• Collaborates with interdisciplinary team members, physicians, patients, and families to support quality care and safe transitions
• Communicates with insurance providers and payers for authorization and continued stay approvals
• Documents all activities, decisions, communications, and patient education in the EMR
• Participates in performance improvement initiatives, utilization review, and data collection efforts for administrative reporting
• Conducts 48-hour post-discharge follow-up calls as applicable
• Advocates for the patient and serves as a liaison between healthcare providers, patients, families, and community resources
• Assists with readmission assessments and care coordination strategies
• Keeps current with Medicare/Medicaid rules, CMS guidelines, and payer requirements

Knowledge/Skills/Abilities/Expectations

• Advanced understanding of case management principles, patient advocacy, and discharge planning
• Strong critical thinking, time management, and problem-solving skills
• Excellent interpersonal and communication abilities
• Familiarity with utilization management, payer authorization processes, and EMR systems
• Capacity to work independently and collaboratively in a high-pressure environment
• Commitment to maintaining patient confidentiality and upholding ethical standards
• Ability to prioritize multiple responsibilities and adjust to changes in work schedule or patient needs

  Education

  • Associate Degree in Nursing, required
  • Bachelor of Science in Nursing (BSN), preferred

  Licenses/Certifications

  • Current and valid Registered Nurse license in the state of practice or Compact State RN license
  • Basic Life Support (BLS) – required within time frame specified in facility policy
  • Accredited Case Manager (ACM) Certification as required by facility policy

  Experience

  • Minimum of 1-2 years of clinical experience in an acute hospital, clinic, home health, hospice, or mental health facility, required
  • Previous case management experience preferred