RN Case Manager: Care Coordination & Transitions

Premier Health Partners; Dayton (OH); On-site; USD 70,000 - 90,000; Full time

Job summary

Premier Health Partners is seeking a Case Manager (RN) at Miami Valley Hospital North in Dayton, Ohio. The RN will assess patients, coordinate care, and plan transitions to optimize outcomes, length of stay, and resource use within established care guidelines.

The role requires an Ohio RN license and BSN; certification in specialty areas is preferred. At least three years of relevant experience is expected, with some background in documentation management and reimbursement processes.

Qualifications

• RN license in Ohio is required.
• BSN is required.
• Three years of clinical experience in the relevant patient population in the last five years preferred.
• Experience with clinical documentation management programs preferred.
• Healthcare reimbursement, discharge planning and case management expertise preferred.
• Knowledge of InterQual ISD-A and Milliman Guidelines and third party insurance requirements is preferred.

Responsibilities

• Assess patients and coordinate individualized care and transition planning to optimize stays and resource use.
• Lead interdisciplinary team collaboration and act as liaison among patient, physician, payor and family for care coordination.
• Promote care coordination and efficient use of healthcare resources across hospitalization and the continuum.

Skills

Interpersonal skills

Negotiation

Conflict resolution

Assertive communication

Microsoft Office

Reimbursement knowledge

Education

BSN

Job description

Premier Health Partners is seeking a Case Manager (RN) at Miami Valley Hospital North in Dayton, Ohio. The RN will assess patients, coordinate care, and plan transitions to optimize outcomes, length of stay, and resource use within established care guidelines.

The role requires an Ohio RN license and BSN; certification in specialty areas is preferred. At least three years of relevant experience is expected, with some background in documentation management and reimbursement processes.