Employment Type:Full timeShift:

Description:

The RN Case Manager collaborates with the Care Coordination team to manage patient care during hospitalization and ensure a smooth discharge process. The role includes working with healthcare providers to support safe and effective care transitions.

Key Responsibilities:

Review admissions and ensure hospitalizations meet established criteria (concurrent and post-discharge).Negotiate lengths of stay and create transitional plans with providers.Use Milliman Care Guidelines for appropriate status determination and communicate status changes.Monitor insurance coverage, provide clinical info for approvals/denials, and advocate through peer-to-peer reviews with insurers.Complete holistic assessments of patient needs, including medical, emotional, and community resources.Coordinate with multidisciplinary teams to develop care plans and ensure continuity of care.Assist with referrals for follow-up appointments, discharge needs (e.g., SNF, hospice, home health), and patient education.Conduct discharge follow-up calls and assist with insurance denials or status corrections.Lead and participate in departmental meetings, community coalitions, and care coordination rounds.Facilitate care transitions and address gaps in care to prevent fragmented services.

Qualifications:

Experience: Minimum 5 years of clinical nursing experience. At least 2 years in case management preferred.Education/Licensure: Current Iowa RN license required; Associate's degree required, BSN preferred.Skills: Strong communication and organizational skills; proficiency in computer use; knowledge of patient care across all age groups.Certifications: Case Management certification and Mandatory Reporter training within 3 months of hire.Additional Requirements: Ability to manage complex cases, advocate for patients, and work well within multidisciplinary teams.

Working Conditions:

Must attend 85% of departmental meetings and in-services.Professional demeanor required in all interactions.Must be able to handle stressful situations and maintain a commitment to high-quality patient care and customer service

Our Commitment to Diversity and Inclusion
 

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.