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Job DescriptionJob Description Job Summary
If you are considering sending an application, make sure to hit the apply button below after reading through the entire description. We are seeking an experienced Inpatient RN Care Manager for one of our clients to coordinate care and services for hospitalized patients, ensuring safe, timely, and cost-effective transitions to the next appropriate level of care. The Care Manager partners closely with physicians, interdisciplinary teams, patients, and families to address clinical, psychosocial, and financial needs while promoting optimal resource utilization and patient outcomes.
Key Responsibilities
· Conduct comprehensive clinical assessments and develop individualized case management plans in collaboration with physicians and the interdisciplinary care team.
· Coordinate and monitor patient progression throughout hospitalization to support timely discharge and achievement of clinical targets.
· Identify high-risk patients requiring psychosocial intervention and refer to Social Services as appropriate.
· Develop, implement, and continuously update discharge and transition-of-care plans to meet changing patient needs.
· Proactively assess and intervene to prevent hospital readmissions; analyze readmission causes and implement prevention strategies.
· Monitor length of stay (LOS) and actively participate in care rounds to identify and address barriers to discharge.
· Collaborate with Utilization Review staff to ensure appropriate level of care and compliance with payer requirements.
· Communicate financial or payer-related issues that may impact post-acute care planning to patients, caregivers, and the care team.
· Educate patients, families, and healthcare staff on care progression, resource utilization, and safe transitions across the continuum of care.
· Maintain working knowledge of federal, state, and regulatory requirements, including CMS, Medicare, Joint Commission standards, Observation status, the Two-Midnight Rule, and Medicare Inpatient-Only procedures.
· Identify potential quality or risk management concerns and escalate through appropriate channels as needed.
Required Skills & Experience
· Active Registered Nurse (RN) license (state-appropriate).
· Prior clinical experience caring for hospitalized patients.
· Strong communication, negotiation, and conflict-resolution skills.
· Proficiency with electronic medical records and data management tools.
· Knowledge of state and federal regulatory standards related to inpatient case management. xmcpwfu
· Experience with performance improvement or rapid cycle change initiatives.
Work Environment
· Hospital-based inpatient setting
· Collaborative, interdisciplinary team environment