University Of Michigan
RN CASE MANAGER: University Hospital (Care Management)
University Of Michigan, Ann Arbor, Michigan, us, 48113
RN CASE MANAGER: University Hospital (Care Management)
The RN Case Manager assesses, develops, implements, coordinates, and monitors a comprehensive plan of care for each patient/family in collaboration with the physician, social worker, and all members of the interdisciplinary team in the inpatient and emergency department patient care areas. The position creates a balance between individual clinical needs and the efficient and cost‑effective utilization of resources while promoting quality outcomes.
Organizational Relationships
Reports directly to the Manager of Care Management.
Works closely with the unit‑based MPLAN team to reach unit and organization goals, including length of stay, care transitions, readmissions, and other quality initiatives.
Collaborates with the interdisciplinary team to develop and implement a comprehensive, integrated discharge plan from the emergency department.
Recommends and documents patient classification of all admissions utilizing established criterion set.
Responsibilities
Within 24 hours of admission, interview each patient/family for anticipated needs post‑hospitalization.
Develop day‑to‑day and overall care plans with providers, patients, and nursing staff.
Lead daily care‑coordination rounds to update plans and facilitate implementation.
Initiate discharge plans, including early referrals to home‑care, DME, and infusion services.
Prepare patients/families for discharge, ensuring understanding of follow‑up and resources.
Maintain standard procedures for routine patient/family conferences with social workers.
Ensure patient handovers to next level of care and collaborate with Care Navigators, complex‑care case managers, home‑care, and sub‑acute liaisons.
Support the nursing model of care by collaborating with nursing managers to achieve patient‑ family–centered care goals.
Facilitate increased discharge volume by noon to improve capacity management.
Collect avoidable days information and report findings in care‑management software (Allscripts).
Participate in venues to reduce barriers to discharge.
Conduct clinical reviews on admission; review every 3 days or as requested by payer.
Determine patient classification and ensure compliance with observation and billing requirements.
Communicate with third‑party payers for necessary authorizations.
Obtain anticipated LOS and ensure all team members are aware.
Refer defined cases for medical secondary review and share findings with providers.
Assist Revenue Cycle/HIM with release of adjustments and appeals.
Review all cases with readmission within 30 days and report findings.
Identify cost‑reduction opportunities and participate in utilization‑management venues.
Conduct referrals and consultations with Physician Advisor.
Actively participate in performance planning and individual development.
Maintain current knowledge of case management, utilization management, and discharge planning guidelines.
Professional Development
Engage in the performance‑planning, competency, and individual development processes.
Keep up‑to‑date knowledge of federal, state, and private insurance guidelines for case and utilization management.
Expectations
Knowledge of community resources to coordinate safe discharge from emergency departments.
Excellent interpersonal, communication, and negotiation skills.
Ability to work collaboratively with social workers and interdisciplinary team members.
Strong organizational and time‑management skills.
Required Qualifications
Bachelor of Science in Nursing, Associate’s Degree in Nursing, or Nursing Diploma with a Master’s Degree in Nursing.
Current Michigan Board of Nursing licensure.
Minimum of three (3) years acute‑care RN experience or 3 years case‑management experience with acute‑care patients.
One (1) year of successful leadership or management experience in nursing management, case management, or clinical career ladder advancement.
Desired Qualifications
Two (2) years hospital discharge‑planning experience.
Master’s degree in nursing or related field.
Case‑Management certification (e.g., ACM or CCM).
Proficiency in InterQual criteria and Allscripts.
Experience with quality‑improvement initiatives and home‑care or skilled home‑health services.
Work Schedule
Hours: 40 per week
Shift: 8:00 a.m. – 4:30 p.m. (day shift) with weekend and holiday commitments.
Location: UMH Care Management, Onsite.
Compensation and Benefits
Hourly rate (RSAM Competent RN): $43.10 – $67.03
Shift differentials: Evening $3.00; Night $4.00; Charge Nurse $1.00.
Benefits include medical, dental, vision coverage; 2:1 retirement savings match; tuition and certification support; professional development; and more.
EEO Statement The University of Michigan is an equal employment opportunity employer.
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Organizational Relationships
Reports directly to the Manager of Care Management.
Works closely with the unit‑based MPLAN team to reach unit and organization goals, including length of stay, care transitions, readmissions, and other quality initiatives.
Collaborates with the interdisciplinary team to develop and implement a comprehensive, integrated discharge plan from the emergency department.
Recommends and documents patient classification of all admissions utilizing established criterion set.
Responsibilities
Within 24 hours of admission, interview each patient/family for anticipated needs post‑hospitalization.
Develop day‑to‑day and overall care plans with providers, patients, and nursing staff.
Lead daily care‑coordination rounds to update plans and facilitate implementation.
Initiate discharge plans, including early referrals to home‑care, DME, and infusion services.
Prepare patients/families for discharge, ensuring understanding of follow‑up and resources.
Maintain standard procedures for routine patient/family conferences with social workers.
Ensure patient handovers to next level of care and collaborate with Care Navigators, complex‑care case managers, home‑care, and sub‑acute liaisons.
Support the nursing model of care by collaborating with nursing managers to achieve patient‑ family–centered care goals.
Facilitate increased discharge volume by noon to improve capacity management.
Collect avoidable days information and report findings in care‑management software (Allscripts).
Participate in venues to reduce barriers to discharge.
Conduct clinical reviews on admission; review every 3 days or as requested by payer.
Determine patient classification and ensure compliance with observation and billing requirements.
Communicate with third‑party payers for necessary authorizations.
Obtain anticipated LOS and ensure all team members are aware.
Refer defined cases for medical secondary review and share findings with providers.
Assist Revenue Cycle/HIM with release of adjustments and appeals.
Review all cases with readmission within 30 days and report findings.
Identify cost‑reduction opportunities and participate in utilization‑management venues.
Conduct referrals and consultations with Physician Advisor.
Actively participate in performance planning and individual development.
Maintain current knowledge of case management, utilization management, and discharge planning guidelines.
Professional Development
Engage in the performance‑planning, competency, and individual development processes.
Keep up‑to‑date knowledge of federal, state, and private insurance guidelines for case and utilization management.
Expectations
Knowledge of community resources to coordinate safe discharge from emergency departments.
Excellent interpersonal, communication, and negotiation skills.
Ability to work collaboratively with social workers and interdisciplinary team members.
Strong organizational and time‑management skills.
Required Qualifications
Bachelor of Science in Nursing, Associate’s Degree in Nursing, or Nursing Diploma with a Master’s Degree in Nursing.
Current Michigan Board of Nursing licensure.
Minimum of three (3) years acute‑care RN experience or 3 years case‑management experience with acute‑care patients.
One (1) year of successful leadership or management experience in nursing management, case management, or clinical career ladder advancement.
Desired Qualifications
Two (2) years hospital discharge‑planning experience.
Master’s degree in nursing or related field.
Case‑Management certification (e.g., ACM or CCM).
Proficiency in InterQual criteria and Allscripts.
Experience with quality‑improvement initiatives and home‑care or skilled home‑health services.
Work Schedule
Hours: 40 per week
Shift: 8:00 a.m. – 4:30 p.m. (day shift) with weekend and holiday commitments.
Location: UMH Care Management, Onsite.
Compensation and Benefits
Hourly rate (RSAM Competent RN): $43.10 – $67.03
Shift differentials: Evening $3.00; Night $4.00; Charge Nurse $1.00.
Benefits include medical, dental, vision coverage; 2:1 retirement savings match; tuition and certification support; professional development; and more.
EEO Statement The University of Michigan is an equal employment opportunity employer.
#J-18808-Ljbffr