RN Case Manager-PRN

Overview

PRN/Supplemental RN Case Manager – IU White Memorial & IU Frankfort Hospitals

The PRN/Supplemental RN Case Manager supports IU White Memorial and IU Frankfort hospitals by providing flexible, as-needed case management services to ensure seamless patient care coordination across the care continuum. This role involves working collaboratively with the multidisciplinary team to plan, coordinate, and facilitate patient care from pre-admission through post-discharge, ensuring optimal patient outcomes and appropriate utilization of resources.

Key Responsibilities:

• Support the care coordination process by assessing patient needs and developing individualized care plans.
• Ensure patients are assigned the appropriate level of care, receive necessary services, and transition smoothly to post-discharge care settings.
• Perform accurate, timely, and effective discharge planning in collaboration with clinical teams.
• Communicate with third-party payers to verify coverage and authorization requirements.
• Educate patients and families regarding care plans, medications, and health management.
• Administer education and prevention programs to promote health and wellness.
• Support hospital compliance with regulatory and payer guidelines, including Medicare, Medicaid, and commercial insurance.
• Assist with documentation and software systems such as Cerner, MCCM, SMS, and Windows applications.

Qualifications:

• Associate's Degree in Nursing required. BSN preferred.
• 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.

This position offers flexibility and an opportunity to support our team as needed, contributing to high-quality patient care and operational efficiency across our hospital sites. Apply today, we would love to hear from you!