Registered Nurse Case Manager

Prime Healthcare; Riverdale (GA); On-site; USD 70,000 - 100,000; Full time

Job summary

Southern Regional Medical Center – Riverdale, GA, is seeking an RN Case Manager to coordinate patient care from admission to discharge. The role involves assessing needs, developing care plans, and collaborating with physicians, nurses, and social workers to optimize transitions.

The RN will conduct discharge planning, utilization review, and patient education, ensuring quality, cost-effective outcomes aligned with patient goals.

Qualifications

• RN license valid in the state of Georgia.
• Minimum five years post-graduation nursing experience.
• Experience in case management, discharge planning, or nursing management preferred.

Responsibilities

• Assess patients and coordinate care throughout hospitalization.
• Develop individualized care plans with the healthcare team.
• Oversee discharge planning and referrals to post-acute services.
• Monitor resource use to ensure appropriate care and avoid unnecessary stays.
• Educate patients and families on care plans and post-discharge steps.
• Advocate for patient needs and preferences in care decisions.

Skills

Care coordination

Discharge planning

Utilization review

Patient education

Advocacy

Communication

Computer skills

Education

Registered Nurse license (state)

Tools

Milliman Criteria

InterQual Criteria

BCLS (AHA) certification

Job description

Overview

Shift’s Available: Days

Employment Type: Full Time

Hours: 8 hour days shifts 8am-5pm

Location: Southern Regional Medical Center – Riverdale, GA

We are seeking an RN Case Manager, also referred to as a Registered Nurse Case Manager or RN Clinical Case Manager. An RN Case Manager will oversee and coordinate patient care from admission through discharge to ensure quality, cost-effective outcomes. They assess patients’ needs, develop care plans, and collaborate with physicians, nurses, social workers, and other providers to manage care transitions. RN Case Managers also conduct discharge planning, utilization review, and help patients navigate insurance and healthcare systems.

Responsibilities

• Patient Assessment: evaluate patients’ medical, psychosocial, and discharge needs upon admission and throughout their stay
• Care Coordination: develop and implement individualized care plans in collaboration with the healthcare team to ensure effective treatment and timely interventions
• Discharge Planning: coordinate safe and appropriate discharge plans, including referrals to rehab, home health, or long-term care facilities
• Utilization Review: monitor the use of hospital resources and services to ensure appropriate care and avoid unnecessary treatments or extended stays
• Patient and Family Education: help patients and families understand care plans, post-discharge instructions, and available resources
• Advocacy: advocate for patient needs and preferences, ensuring care is aligned with their goals and values

Qualifications

Education and Work Experience

• Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license (starting April 1 2015)
• Grandfathered prior to April 1, 2015: Minimum 5 years post-graduate of an accredited school of social work for Licensed Clinical Social Worker. RN Case Manager preferred.
• Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management preferred.
• Current BCLS (AHA) certificate upon hire and maintained current.
• Knowledge of Milliman Criteria and InterQual Criteria preferred.
• Experience and knowledge of basic to intermediate computer skills.
• Behavioral Violence Prevention Training within 3 months of hire and maintained current.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf