Pediatric RN Case Manager: Discharge & Care Coordination

10100 Children's Hospital; Washington (District of Columbia); Hybrid; USD 51,000 - 86,000; Full time

Benefits offered by this job

Health coverage

Paid time off

401(k) plan

Life, AD&D, long-term disability

Tuition assistance

Commuter benefits

Job summary

Children’s National Hospital in Washington, DC is seeking a Case Manager (Hybrid I/II) to advocate for children and coordinate care across the hospital and community.

You will lead discharge planning, utilization review, and review hospital days to ensure alignment with payer guidelines while helping families access Medicaid, Medicare, and other resources. Join a collaborative team focused on improving outcomes for high-risk patients.

Qualifications

• Bachelor’s Degree (Required).
• Master’s Degree (Preferred).
• Five (5) years’ experience with at least three (3) years in an acute inpatient setting (Required).
• Experience in Case Management/Utilization Management, preferred.
• DC RN license and case management/utilization management credentials preferred.

Responsibilities

• Lead discharge planning and utilization review, coordinating care across the care continuum.
• Review and authorize hospital days to align with payer guidelines and minimize denials.
• Identify barriers to discharge (social determinants of health) and connect families with resources.
• Manage a patient panel, using data-driven insights to reduce readmissions and optimize resources.
• Collaborate with interdisciplinary teams to ensure high-quality, equitable care.

Education

Bachelor’s Degree (Required)

Master’s Degree (Preferred)

RN license in DC (Required)

Current certification in Case Management or Utilization Management (Preferred)

Job description

Children’s National Hospital in Washington, DC is seeking a Case Manager (Hybrid I/II) to advocate for children and coordinate care across the hospital and community.

You will lead discharge planning, utilization review, and review hospital days to ensure alignment with payer guidelines while helping families access Medicaid, Medicare, and other resources. Join a collaborative team focused on improving outcomes for high-risk patients.