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• Care Team Participation: Work as part of the interdisciplinary care team to improve clinical outcomes, patient satisfaction, and efficient care delivery.
• Utilization Management: Coordinate utilization management efforts to ensure that care is appropriate, timely, and cost-effective.
• Care Facilitation: Manage the facilitation of care across various settings and ensure continuity of services for patients.
• Discharge Planning: Develop and implement discharge plans in collaboration with other healthcare providers to ensure smooth transitions of care.
• Caseload Management: Accountable for a designated patient caseload, planning care to meet individual patient needs and promoting effective use of resources.
• Length of Stay Management: Monitor and manage the length of stay for patients, ensuring that care is delivered efficiently and without unnecessary delays.
• Patient and Family Support: Provide support and education to patients and their families regarding care plans, discharge instructions, and resources available to them.
• Collaboration: Communicate with payers to ensure timely and accurate information regarding patient care and treatment plans.

• Registered Nurse (RN) License with a valid, active license in the state of employment.
• Proven experience in care coordination or case management.
• Strong understanding of utilization management, discharge planning, and patient care facilitation.
• Excellent communication skills, both written and verbal, to collaborate effectively with interdisciplinary teams, patients, and families.
• Knowledge of healthcare payer systems and insurance processes.
• Ability to manage and prioritize a caseload effectively.
• Ability to make decisions based on clinical judgment, patient needs, and organizational goals.
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• Certifications in Care Coordination or Case Management (e.g., CCM, ACM).
• Previous experience working in a hospital or clinical setting.
• Familiarity with electronic health record (EHR) systems and case management software.

1. Certified Case Manager (CCM) or Accredited Case Manager (ACM) certification (preferred).

Certification: Certified Case Manager , Accredited Case Manager