Case Manager RN Per Diem

Northwell Health; Norwalk (CT); On-site; USD 63,273 - 117,495; Full time

Job summary

Northwell Health is looking for a Case Manager RN in Norwalk to work with interdisciplinary teams for hospitalized patients. Key responsibilities include facilitating care progression, collaborating on treatment plans, and navigating health-system services. A strong emphasis is placed on communication and problem-solving skills as well as a commitment to compliance with industry standards.

Candidates should possess an Associate Degree in Nursing, a Registered Nurse license in CT, and relevant experience. This role does not require manual skills but focuses on managing care for optimal patient outcomes.

Qualifications

• 3 years of job-related experience.
• Registered Nurse license in the State of CT.
• At least one year as an acute-care coordinator.

Responsibilities

• Screen and assess hospitalized patients for care transitions.
• Collaborate with medical teams to formulate treatment plans.
• Ensure clinical follow-up and referrals are arranged.

Skills

Collaboration

Problem-solving

Communication

Education

Associate Degree in Nursing

Certification in Case Management (preferred)

Bachelor's Degree in Nursing (preferred)

Tools

Electronic medical records

InterQual screening criteria

Milliman screening criteria

Job description

Weekends and Holidays, 8:30‑5:00 pm

Summary

The Case Manager RN works with the centralized denial prevention team and the local interdisciplinary care team to facilitate the progression of care for hospitalized patients. The role collaborates with the medical provider and other team members to deliver efficient, high‑quality care, ensuring appropriate utilization of clinical resources with a goal of safe and timely discharge. The RN navigates health‑system services to support effective transitions while advising the team on industry compliance and driving throughput metrics, clinical effectiveness, and fiscal responsibility.

Responsibilities

• Initially screen all patients early in the hospitalization, particularly those likely to need post‑acute care, and re‑screen every 1–2 days to establish an anticipated length of stay and transition planning needs.
• Collaborate with the medical team to formulate a treatment plan that includes care transitions and promotes patient flow.
• Complete an initial assessment of all admissions/observation patients to identify barriers that impact length of stay and discharge planning, and anticipate future resources needed to facilitate successful transitions.
• Navigate the care delivery system, ensuring that tests, treatments, consults, and procedures are indicated and performed in a timely manner.
• Articulate the plan of care and communicate it to other team members and the patient/caregiver; intervene to maintain care progression when a deviation occurs.
• Create and coordinate the overall transition plan of care based on initial assessment and collaboration with social workers, direct care providers, other hospital departments, external service organizations, agencies, healthcare facilities, and community care and navigation services.
• Facilitate daily Multidisciplinary Rounds, incorporating evidence‑based milestones, and communicate the plan to the health‑care team.
• Inform the interdisciplinary team of the estimated length of stay, care progression barriers, and anticipated disposition, identifying what is needed to facilitate the plan.
• Ensure appropriate clinical follow‑up is arranged and referrals to post‑acute providers are initiated for smooth transitions.
• Communicate the plan effectively with the patient and family/caregiver, ensuring they have resources for success post‑discharge and understand organizational goals for length of stay and readmissions.
• Interface with the payer to verify coverage/benefits for anticipated discharge needs and obtain authorization for post‑acute care where required.
• Identify patients at high risk for unplanned readmissions and initiate appropriate interventions, engaging community resources as necessary.
• Document avoidable days, case‑management assessments, and care plans in a thorough and timely manner per department policy.
• Ensure provider documentation supports the patient’s anticipated discharge plan of care and escalates deviations to the Physician Advisor when necessary.
• Communicate problems or issues affecting patient flow, satisfaction, safety, length of stay, or outcomes to the department director and key stakeholders.
• Serve as a resource for governmental and health‑care industry regulations, ensuring compliance and communicating standards to the interdisciplinary team.
• Facilitate care partner huddles, family meetings, departmental staff meetings, and other committees or workgroups as directed.
• Manage quality indicators such as avoidable delays, length of stay, resource utilization, patient satisfaction, patient flow, outlier management, and readmissions, and suggest strategies to improve performance.
• Assist with completion of PRIs upon request and as needed.
• Maintain and model the organization’s values and demonstrate regular, reliable, and predictable attendance.
• Perform other duties as required.

Education, Skills, Experience

Required: Associate Degree in Nursing, 3 years of job‑related experience, and a Registered Nurse license in the State of CT with at least one year as an acute‑care coordinator.

Knowledge of electronic medical records and use of InterQual and Milliman screening criteria.

Strong collaboration and teamwork skills, ability to work closely with physicians and all care‑team members to procure the right level of care and optimize the plan of care.

Knowledge of CMS, insurance industry standards, and guidelines for coverage notifications.

Resourceful problem‑solving skills and excellent oral and written communication.

Desired: Certification in Case Management preferred or willing to obtain; Bachelor’s Degree in Nursing preferred.

Other Information

Working Conditions:

Manual: Little or no manual skills/motor coordination needed; finger dexterity negligible.

Occupational: Little or no potential for occupational risk.

Physical Effort: Sedentary/light effort; may exert up to 10 lbs of force.

Physical Environment: Generally pleasant working conditions.

Company: Norwalk Hospital Association

Org Unit: 374

Department: Care Coordination‑NH

Exempt: No

Salary Range: $45.93‑$85.29 Hourly