RN Case Manager

Medasource; Indiana (PA); Remote; USD 65,000 - 85,000; Full time

Job summary

A leading company is seeking an RN Case Manager to coordinate patient care from pre-admission to post-discharge. This role involves working with a multidisciplinary team to ensure patients receive appropriate services and care levels. Candidates must have an Associate's Degree in Nursing and an active RN license in Indiana. The position offers a 6-month contract with the potential for permanent employment.

Qualifications

• Requires active RN license in Indiana or NLC RN license.
• Certification in Case Management preferred.
• 3-5 years of experience preferred.

Responsibilities

• Plans and coordinates care for patients from pre-admission through post-discharge.
• Ensures appropriate level of care and services for patients.
• Works with third-party payers to ensure coverage.

Skills

Knowledge of Medicare/Medicaid

Knowledge of InterQual Acute Level of Care Criteria

Understanding of the third-party denial and appeal process

Education

Associate's Degree in Nursing

Tools

Cerner

MCCM

SMS

Windows

Job description

Get AI-powered advice on this job and more exclusive features.

Location: Remote, Must reside in Indiana

Duration: 6-month contract, with the possibility of going permanent

The RN Case Manager plans and coordinates care for patients from pre-admission through post-discharge by working collaboratively with the multidisciplinary team. Ensures that patients are assigned the appropriate level of care, receive the appropriate services, and are transitioned to the appropriate post-discharge level of care. Performs accurate, timely, and effective discharge planning for patients. Works with third-party payers to ensure coverage. Administers education and prevention programs.

• Associate's Degree in Nursing required.
• Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.
• Certification in Case Management preferred.
• Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation, is preferred.
• Knowledge of Medicare/Medicaid, insurance, and regulatory guidelines is preferred.
• Ability to comprehend third-party contractual arrangements is preferred.
• Understanding of the third-party denial and appeal process is preferred.
• Requires knowledge of various software applications including Windows, Cerner, MCCM, and SMS.
• 3-5 years of experience preferred.

Seniority level

• Associate

Employment type

• Full-time

Job function

• Health Care Provider

Industries

• Hospitals and Health Care