RN Care Manager: Elevate Transitions & Patient Outcomes

Mclaren-Health-Care; Lansing (MI); On-site; USD 72,000 - 92,000; Full time

Job summary

McLaren Health Care in Michigan seeks a Registered Nurse Care Manager within Case Management to coordinate patient transitions to the appropriate level of care. You will work with physicians, nurses, social services, and post-acute providers to prevent readmissions and optimize length of stay.

The role requires RN licensure, a Bachelor’s degree in nursing, and at least three years of acute hospital experience. Strong collaboration and EMR documentation are essential to success.

Qualifications

• RN licensure required
• Bachelor’s degree in nursing or to be obtained within five years
• Three years of acute hospital care experience

Responsibilities

• Performs care coordination assessments for initial patient assessment within 24 hours of admission.
• Collaborates with social worker and disciplines to ensure safe transition to next level of care.
• Assesses patient/family needs to reduce barriers and plan discharge.
• Identifies and communicates level of care and discharge needs with providers.
• Reviews DRG/LOS to assess discharge planning with providers.
• Assesses readmission risk and initiates interventions for successful transitions.
• Refers to social services, outpatient case management, and post-acute agencies as needed.
• Liaises daily with physician, patient, family, nursing, and team members.
• Participates in interdisciplinary rounds.
• Documents EMR with assessments, plans, and reassessments for discharge.
• Identifies barriers early and plans with patient/family and care team.
• Reports avoidable delays from the established plan of care to leadership.
• Represents integrated care management on teams and outcomes committees.
• Ensures follow-up PCP appointments are made prior to discharge.
• Maintains operations by following policies and procedures.
• Performs other related duties as required.

Education

Bachelor’s degree in nursing

Job description

McLaren Health Care in Michigan seeks a Registered Nurse Care Manager within Case Management to coordinate patient transitions to the appropriate level of care. You will work with physicians, nurses, social services, and post-acute providers to prevent readmissions and optimize length of stay.

The role requires RN licensure, a Bachelor’s degree in nursing, and at least three years of acute hospital experience. Strong collaboration and EMR documentation are essential to success.