RN Care Manager: Transitions & Discharge Navigator

McLaren Health Care; Mount Clemens (MI); On-site; USD 65,000 - 85,000; Full time

Job summary

McLaren Health Care in Michigan is seeking a Care Manager to coordinate and transition patients to appropriate level of care, reduce LOS, and prevent readmissions. You will collaborate with physicians, nursing, social work, Home Care, PCP offices and other resources across the system.

Responsibilities include initial assessments within 24 hours, discharge planning, resolving barriers, identifying LOC orders, reviewing DRG/LOS, and arranging referrals to social services and post-acute providers.

Qualifications

• State licensure as an RN.
• Bachelor’s degree in nursing or actively pursuing within five years.
• Three years of acute hospital care experience.

Responsibilities

• Performs care coordination assessments for initial assessment of patients within 24 hrs of admission.
• Collaborates with social worker and disciplines for safe, timely transition to next level of care.
• Assesses patient/family needs to reduce barriers and formulate discharge plans.
• Identifies unsigned LOC orders; communicates with utilization management nurse and providers.
• Reviews DRG/LOS in Cerner to assess discharge planning needs and identify contact person.
• Assesses risk of readmission and initiates interventions to support transition.
• Performs discharge planning coordination/referral to social services, outpatient case management, and post-acute placement.

Skills

Care coordination

Discharge planning

Interdisciplinary collaboration

RN licensure

BSN degree

Case management knowledge

BLS certification

Cerner

Education

Bachelor’s degree in nursing

Pursuing degree within five years

Tools

Cerner

Job description

McLaren Health Care in Michigan is seeking a Care Manager to coordinate and transition patients to appropriate level of care, reduce LOS, and prevent readmissions. You will collaborate with physicians, nursing, social work, Home Care, PCP offices and other resources across the system.

Responsibilities include initial assessments within 24 hours, discharge planning, resolving barriers, identifying LOC orders, reviewing DRG/LOS, and arranging referrals to social services and post-acute providers.