RN Case Manager
Location: ,
Job Type: Federal
Company: Decypher
Category: Medical Services
Job Description Apply Now
The RN Case Manager is a critical nursing professional responsible for overseeing and executing comprehensive case management programs, ensuring the delivery of high-quality patient care. As an RN Case Manager, you will play a pivotal role in coordinating patient services, collaborating with interdisciplinary teams, and supporting optimal patient outcomes through effective care planning, assessment, and intervention. This full-time opportunity allows you to bring your clinical expertise and case management skills into an impactful role where you can make a meaningful difference in patient lives. The RN Case Manager position is based onsite and offers the unique benefit of relocation assistance and work VISA sponsorship, making it an excellent opportunity for licensed U.S. nurses seeking to expand their professional horizons internationally. Working in this location provides a distinctive cultural and professional experience, supporting both personal growth and career development.
As an RN Case Manager, you will be at the forefront of the Case Management Program (CMP), taking part in all stages of the program and ensuring adherence to established standards of care. Your responsibilities will include providing expert guidance on the case management process, encompassing assessment, planning, implementation, coordination, and ongoing monitoring. You will identify opportunities to enhance case management strategies and integrate local processes to improve patient care delivery. Utilizing your clinical judgment and experience, you will develop and implement tools such as patient identification systems, assessment protocols, clinical guidelines, algorithms, and case management software to support these efforts.
The RN Case Manager also plays a vital role in integrating case management with utilization management (UM) and in collaborating with social work case managers to ensure a holistic approach to patient care. You will act as a key liaison with community agencies and organizations, fostering relationships that support patient wellness and continuity of care. Accurate data collection and meticulous documentation of patient care are essential components of this role, as is developing individualized treatment plans addressing preventive, therapeutic, rehabilitative, psychosocial, and clinical needs. You will be responsible for establishing mechanisms to implement and follow up on treatment plans, ensuring patients receive appropriate care post-discharge in ambulatory and community healthcare settings.
Your expertise will also be leveraged to educate patients and caregivers based on their specific learning needs, empowering them to engage actively in their care and recovery. The RN Case Manager is expected to interpret and apply medical care criteria such as InterQual or Milliman Ambulatory Care Guidelines, perform various types of reviews to justify the medical necessity of care, and possess proficiency in coding systems including APGs, DRGs, ICD-9, and CPT-4.
To be successful in this role, you must hold an Associate Degree in Nursing and have graduated from an institution accredited by the Accreditation Commission for Education in Nursing (ACEN), the Commission on Collegiate Nursing Education (CCNE), or an equivalent accrediting body. A minimum of two years of recent professional nursing experience within the last four years is required, and previous case management or utilization management experience is highly valued. You must also possess one of several recognized certifications, such as the Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Certified Rehabilitation Registered Nurse (CRRN), Certified Occupational Health Nurse (COHN/COHN-S), Advanced Certification in Continuity of Care (ACCC), Certified Rehabilitation Counselor (CRC), Nurse Case Manager (RN-NCM), or Care Manager Certified (CMC).
This position offers the opportunity to work in a supportive and collaborative environment, surrounded by dedicated healthcare professionals. You will have access to ongoing professional development and the chance to contribute to the continuous improvement of patient care delivery. If you are a compassionate, detail-oriented, and organized nurse with a passion for case management, we encourage you to apply for the RN Case Manager position by clicking the application button today and take the next step in your nursing career.
RN Case Manager - Summary- Onsite, full-time RN Case Manager role, supporting comprehensive case management for diverse patient populations.
- Relocation assistance and work VISA support provided.
- US nursing license and relevant certification required.
- Engage in all phases of the Case Management Program, ensuring adherence to established standards.
- Participate in all stages of the Case Management Program (CMP) and ensure compliance with case management standards of care.
- Deliver nursing expertise in the assessment, planning, implementation, coordination, and monitoring of patient care.
- Identify and integrate opportunities for enhancing local case management processes.
- Develop and utilize tools for patient identification, assessment, and care planning, including clinical guidelines and case management software.
- Integrate case management and utilization management, collaborating with social work case managers.
- Maintain liaisons with community agencies and organizations to support patient wellness.
- Document patient care data accurately and develop individualized treatment plans.
- Establish and monitor mechanisms for treatment plan implementation and post-discharge follow-up.
- Provide health care education to patients and caregivers based on learning needs.
- Relocation assistance package available.
- Work VISA sponsorship provided.
- Competitive compensation package aligned with qualifications and experience.
- Opportunities for ongoing professional development and growth.
- Associate Degree in Nursing from an ACEN or CCNE-accredited institution, or equivalent.
- Current, unrestricted US nursing license.
- Minimum two (2) years of recent professional nursing experience within the last four (4) years.
- Previous case management and/or utilization management experience preferred.
- Proficiency in medical review criteria, coding systems, and computer literacy.
- One of the following certifications: CCM, CDMS, CRRN, COHN, COHN-S, ACCC, CRC, RN-NCM, or CMC.
- Detail-oriented, organized, and compassionate registered nurse.
- Strong communication and collaborative skills for interdisciplinary teamwork.
- Proactive in patient advocacy and committed to high standards of care.
- Experienced in case management tools and clinical guidelines.
- Able to adapt to diverse patient needs and healthcare environments.
- This is an onsite position; remote work is not available.
- Applicants must meet all licensure and certification requirements prior to employment.
- Experience with international or multicultural patient populations is a plus.
- Apply now to take advantage of relocation support and an exciting opportunity to advance your career as an RN Case Manager!