RN Case Manager — Care Coordination & Discharge

Equiliem; Philadelphia (Philadelphia County); On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Medical Insurance

Vision & Dental Insurance

Life Insurance

Matching 401(k)

Commuter Benefits

Employee Discounts & Rewards

Payroll Payment Options

Job summary

Equiliem is seeking a Case Manager (RN) to provide clinically focused care coordination and discharge planning across hospitalization. You will collaborate with patients, families, physicians, social workers, payers, and the care team to facilitate timely progression of care and smooth transitions.

Responsibilities include developing discharge plans, coordinating post-acute services, communicating payer determinations, and using risk scores to target high‑risk patients.

Qualifications

• Must have 5+ years of nursing or healthcare experience.
• Active Pennsylvania RN license.
• Knowledge of managed care admission processes, benefit verification, and admission notifications.
• Strong understanding of care coordination, utilization management, and discharge planning.

Responsibilities

• Assess patients and families to identify transition-of-care needs and develop discharge plans.
• Initiate discharge planning on admission and manage plans throughout hospitalization.
• Evaluate risk scores and implement enhanced care coordination for high-risk patients.
• Reassess discharge plans at least every 8 business days or with condition changes.
• Communicate authorization approvals, denials, and payer determinations to the care team.
• Collaborate with physicians, nursing, social work, rehabilitation services and others to address barriers to discharge.
• Monitor progress toward discharge goals and intervene when progression is delayed.
• Lead interdisciplinary rounds and complex case discussions.

Skills

Communication

Organizational skills

Interpersonal skills

Time management

Customer service

Microsoft Office

Excel

Word

Education

Technical Diploma in Nursing

Bachelor's Degree in Nursing (BSN)

Tools

Microsoft Office

Word

Excel

Job description

Equiliem is seeking a Case Manager (RN) to provide clinically focused care coordination and discharge planning across hospitalization. You will collaborate with patients, families, physicians, social workers, payers, and the care team to facilitate timely progression of care and smooth transitions.

Responsibilities include developing discharge plans, coordinating post-acute services, communicating payer determinations, and using risk scores to target high‑risk patients.