Pediatric Case Manager: Discharge & Care Coordination

10100 Children's Hospital; Washington (District of Columbia); Hybrid; USD 78,000 - 129,000; Full time

Benefits offered by this job

Health coverage

Paid time off

401(k) plan

Life/AD&D/Disability

Tuition assistance

Fitness resources

Employee assistance

Commuter benefits

Job summary

Children’s National Hospital in Washington, DC is seeking a Case Manager Hybrid I/II to lead discharge planning and utilization review for complex pediatric patients, coordinating with interdisciplinary teams to ensure a high-quality, efficient care experience.

The role emphasizes collaborating with care teams, addressing social determinants of health, and connecting families with essential community and financial resources to optimize patient outcomes.

Qualifications

• Bachelor’s Degree required.
• Master’s Degree preferred.
• 5 years of experience with at least 3 years in acute inpatient setting required.
• Extensive clinical experience in Case Management and/or Utilization Management preferred.
• Experience in pediatric specialty, program development, and leadership required.
• Registered Nurse license in DC required.
• Current certification in Case Management or Utilization Management preferred.

Responsibilities

• Lead discharge planning and utilization review for complex pediatric patients.
• Coordinate care planning with interdisciplinary teams to ensure high-quality, efficient care.
• Use data to identify opportunities to reduce avoidable admissions and readmissions.
• Review and authorize hospital days in alignment with payer guidelines.
• Link families to community resources, including Medicaid and Medicare programs.
• Support performance improvement and care transitions across the care continuum.

Skills

Discharge planning

Utilization review

Care coordination

Interdisciplinary collaboration

Social determinants of health

Education

Bachelor’s degree

Master’s degree

Job description

Children’s National Hospital in Washington, DC is seeking a Case Manager Hybrid I/II to lead discharge planning and utilization review for complex pediatric patients, coordinating with interdisciplinary teams to ensure a high-quality, efficient care experience.

The role emphasizes collaborating with care teams, addressing social determinants of health, and connecting families with essential community and financial resources to optimize patient outcomes.