Riley Children's Health is Indiana’s largest and most skilled pediatric system, with over 50 locations across the state. As one of the nation’s leading healthcare networks specifically for children, our multidisciplinary team of pediatric primary care and specialists can deliver and coordinate healthcare for every child because we have expertise in all areas of pediatric health. We have the only pediatric research hospital in the state and are ranked among the top hospitals in the nation according to U.S. News & World Report. Through enduring collaborations with the Indiana University School of Medicine, Indiana University School of Nursing and Indiana University School of Health and Human Sciences, Riley Children's Health is one of the top 10 sites in the United States for pediatric health research, drawing millions of dollars in biomedical research investments each year.
Riley Children's Hospital in Indianapolis has an outstanding opportunity available for a Case Manager. Our ideal candidate has previous pediatric experience, but not required. This position works Monday-Friday, day shift. Upon completion of training, there will be an opportunity to work 1 day per week remote. If you are looking for the next step in your nursing career with Indiana's #1 Healthcare system, apply today!
As part of an award-winning hospital system, our part-time and full-time team members have access to a comprehensive benefits package, which includes, Competitive pay, Development opportunities, Tuition reimbursement, Matching 401k, Paid medical leave, and health, dental and vision insurance.
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. New ASN RNs hired after January 1, 2013, will be required to complete their BSN within 5 years of hire date. 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 required. Requires strong clinical background in acute care.