Registered Nurse Care Manager - Case Management (Onsite)

McLaren Health Care; Pontiac (MI); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

403(b)

Dental insurance

Health insurance

Paid time off

Vision insurance

Job summary

McLaren Health Care is seeking a Nurse Case Manager in the Case Management department to coordinate care and ensure timely transitions across the continuum. The role emphasizes preventing readmissions and optimizing LOS through collaboration with physicians, nursing teams, Home Care, PCP offices, and other resources.

Daily work times are 8:00 am – 4:00 pm, with a full-time schedule. The position requires RN licensure, a BSN (or active pursuit within five years), and 3+ years of acute hospital

Qualifications

• State licensure as a Registered Nurse (RN).
• Bachelor’s degree in nursing from an accredited institution, or actively pursuing degree to be obtained within five years of accepting position.
• Three years of acute hospital care experience.
• Preferred: Case management certification (ACM or CCM).
• BLS certification as Healthcare Provider.

Responsibilities

• Performs care coordination assessments within 24 hours of admission and for readmission/transition planning.
• Collaborates with social work and multidisciplinary teams to ensure safe, timely transition to next level of care.
• Assesses patient/family needs to reduce barriers and formulate discharge plans.
• Identifies unsigned level of care orders and communicates with utilization management.
• Reviews DRG/LOS to assess discharge planning needs with providers and identifies the point of contact.
• Assesses risk of readmission and initiates interventions to support transitions.
• Performs discharge planning coordination/referral to social services, outpatient case management, DME, post-acute placement and other agencies.

Education

Bachelor's degree in nursing

RN licensure

Pursuing BSN within five years

Job description

Department:

Case Management

Daily Work Times:

8:00 am - 4:00 pm

Shift:

Days

Scheduled Bi-Weekly Hours:

80

Benefits:

• 403(b)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Position Summary:

Accountable for proactive coordination and timely transition of assigned patients to the most appropriate level of care along the continuum. Impacts key results such as achieving top decile performance in length of stay, cost efficient resource utilization, preventing readmissions and unnecessary emergency room visits. Works collaboratively with physicians, nursing, members of the multidisciplinary team (such as Home Care and PCP offices), as well as other resources internal and external to the organization.

Essential Functions and Responsibilities as Assigned:

• Performs care coordination assessments for initial assessment of patients with 24 hrs. of admission. assessments for readmission and transition planning.
• Works collaboratively with the social worker and other disciplines to ensure a safe, appropriate, and timely transition to the next level of care, taking into consideration the patient’s available resources.
• Assess patient/family needs to reduce barriers and formulate discharge plans (e.g., LOS barriers to D/C).
• Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers.
• Reviews current DRG/LOS identified within Cerner to assess discharge planning needs with providers and identifies which family member is the point of contact.
• Assess risk of readmission for specified patient populations and initiates assigned interventions that will enhance the patient’s ability to successfully transition along the care continuum.
• Performs discharge planning coordination/referral by making appropriate referrals to social services, ancillary departments, outpatient case management, DME, post-acute placement, and other outside agencies per Standard Operating Procedure (SOP).

Qualifications:

Required:

• State licensure as a Registered Nurse (RN)
• Bachelor’s degree in nursing from accredited educational institution, or actively pursuing degree and to be obtained within five years of accepting position.
• Three years of acute hospital care experience

Preferred:

• Experience in utilization management/case management, critical care, or patient outcomes/quality management
• Certification in Case Management Certification (ACM or CCM)
• Basic Life Support (BLS) certification as a Healthcare Provider by the American Heart Association, American Red Cross or equivalent through the Military Training network (MTN)

Additional Information

• Schedule: Full-time
• Requisition ID: 26012173
• Daily Work Times: 8AM - 4PM
• Hours Per Pay Period: 80
• On Call: No
• Weekends: Yes