RN Clinical Coordinator/Case Manager (50/50 Role)

Licking Memorial Health Systems; Newark (OH); On-site; USD 65,000 - 90,000; Full time

Job summary

Licking Memorial Health Systems seeks an RN to fill a dual Clinical Coordinator and Case Manager role, dedicating roughly 50% of time to clinical coordination and 50% to direct patient case management. The position supports care management processes while maintaining an active caseload to ensure quality, patient-centered care across the continuum.

The role requires strong clinical judgment, leadership, excellent communication, and the ability to balance operations with direct patient care in a

Qualifications

• Current RN licensure in Ohio
• 2 years active Acute Case Management Experience
• Obtain Case Management Certification within one year of employment
• Current CPR card and maintain.

Responsibilities

• Serve as the primary clinical administrator for Case Management/Utilization Review applications such as MCG-Milliman Care Guidelines, R1-Physician Advisor, Payer Portal Administrator
• Coordinate all aspects of new hire orientation including Development of Orientation Calendar, Assignment of Preceptors, Hardware/Software Needs and Accesses
• Develop/Ensure Annual Case Management Competencies (MCG: Interrater Reliability; MCG LMS Coursework; DNV/JC Case Management Competencies)
• Collaborate with Health System Clinical Coordinators (Preceptor Training)
• Develop and Maintain Case Management Education Calendar (EPIC upgrades/changes)
• Develop/Maintain CM Database with CM education/resources
• Maintain knowledge of CM functions/workflows (Utilization Review, Denials/Appeals, Discharge Planning, Medicare Compliance, Mental Health/Substance Use, Readmission Reduction)
• Perform all duties as assigned in Case Management Role

Skills

Clinical coordination

Case management

Regulatory compliance

Leadership

Communication

Tools

EPIC

Payer Portal

Job description

Position Summary

The Clinical Coordinator/Case Manager serves in a dual-capacity role, dedicating approximately 50% of time to clinical coordination and department operations and 50% of time to direct patient case management activities. This position supports the coordination and oversight of care management processes while maintaining an active caseload to ensure high-quality, patient-centered care across the continuum.

Job Details

Description

RN Case Manager

Position Summary

The Clinical Coordinator/Case Manager serves in a dual-capacity role, dedicating approximately 50% of time to clinical coordination and department operations and 50% of time to direct patient case management activities. This position supports the coordination and oversight of care management processes while maintaining an active caseload to ensure high-quality, patient-centered care across the continuum.

As a Clinical Coordinator, the incumbent provides day-to-day operational support, assists with workflow management, staff onboarding and education, quality initiatives, compliance monitoring, and serves as a resource to the interdisciplinary team. The role promotes adherence to regulatory requirements, organizational policies, and best practices in care coordination and utilization management.

As a Case Manager, the incumbent conducts patient assessments, develops and implements individualized discharge plans, coordinates transitions of care, collaborates with physicians and interdisciplinary team members, and advocates for patients to ensure appropriate utilization of resources and timely progression of care. The role focuses on achieving optimal clinical, financial, and patient satisfaction outcomes while supporting safe and effective care transitions.

This position requires strong clinical judgment, leadership skills, effective communication, and the ability to balance operational responsibilities with direct patient care coordination in a fast-paced healthcare environment.

Responsibilities

• Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as:




• MCG- Milliman Care Guidelines


• R1- Physician Advisor


• Payer Portal Administrator




• Coordinate all aspects of new hire orientation including (not all inclusive):




• Development of Orientation Calendar


• Assignment of Preceptors


• Hardware/ Software Needs and Accesses


• Preceptor/ Preceptee Documentation-Support


• Develop/ Maintain New Hire Orientation Manuals




• Develop/ Ensure Annual Case Management Competencies




• MCG: Interrater Reliability


• MCG LMS Coursework


• DNV/JC Case Management Competencies




• Collaborate with Health System Clinical Coordinators




• Preceptor Training




• Develop and Maintain Case Management Education Calendar




• Design and Facilitate Education surrounding EPIC upgrades/ changes.


• Facilitate clinical education on current best practices




• Develop/ Maintain CM Database with all CM related education/ resources


• Serve as Expert/ Maintain knowledge of all CM related functions and workflows including:




• Utilization Review


• Denials/ Appeals Management


• Discharge Planning


• Medicare Compliance


• Mental Health/ Substance Use


• Readmission Reduction




• Perform all duties as assigned in Case Management Role

Requirements

• Current R.N. licensure in Ohio (must be maintained)


• 2 years active Acute Case Management Experience


• Obtain Case Management Certification within one year of employment in role


• Current CPR card and maintain.


• Maintain knowledge of new technology and equipment


• Ability to work independently.


• Successful candidate must have excellent critical thinking skills.


• LMH is accredited by DNV and TJC, and as such, may require specific annual education related to specialty certifications and standards.

Licking Memorial Health Systems is an equal opportunity employer and maintains compliance with all state, federal, and local regulations. Licking Memorial Health Systems does not discriminate against applicants because of race, color, religion, sex, sexual orientation, age, ancestry, national origin, veteran status, pregnancy, disability, marital status, or other characteristics protected by law.