Part-Time Case Management RN: Coordinate Care

Wilson-Health; Buckeye Terrace (OH); On-site; USD 45,000 - 70,000; Part time

Benefits offered by this job

Free medical care on-site clinic

PTO from day one

Health insurance options

HSA employer contribution

Life insurance

Tuition assistance

On-site gym

Job summary

Wilson Health is seeking a part-time Case Management RN to join our Case Management team. The RN coordinates patient care, supports discharge planning, ensures appropriate utilization of resources, and promotes positive patient outcomes across the continuum of care.

This role collaborates with physicians, nursing, payers, and community resources; strong knowledge of utilization review and medical necessity is essential. BSN preferred; Ohio RN license required.

Qualifications

• Graduate of an accredited school of nursing.
• BSN preferred.

Responsibilities

• Perform utilization review activities to evaluate admission, length of stay, level of care, documentation, and standards of care.
• Assess patients for physical, psychological, functional, social, environmental, and financial needs affecting plan of care.
• Develop and coordinate discharge plans with patients, families, physicians, nursing, and community providers.
• Identify barriers to discharge and coordinate resources for safe transitions of care.
• Review treatment plans and coordinate appropriate care options.
• Participate in multidisciplinary rounds and collaborate on patient progression and discharge readiness.
• Serve as a resource on utilization management, length of stay, and discharge planning needs.
• Document to support medical necessity and regulatory requirements.
• Refer cases to Utilization Review Physician Advisor.
• Assist with denials and appeals and with revenue cycle opportunities.
• Perform case reviews and audits to ensure standard care and appropriate utilization.

Skills

Clinical assessment

Utilization review

Discharge planning

Coordination of care

Communication

Documentation

Multidisciplinary teamwork

Problem-solving

Regulatory knowledge

Education

Bachelor of Science in Nursing (BSN)

Graduate of an accredited nursing program

Job description

Wilson Health is seeking a part-time Case Management RN to join our Case Management team. The RN coordinates patient care, supports discharge planning, ensures appropriate utilization of resources, and promotes positive patient outcomes across the continuum of care.

This role collaborates with physicians, nursing, payers, and community resources; strong knowledge of utilization review and medical necessity is essential. BSN preferred; Ohio RN license required.