ER RN Case Manager Night Shift - Remote

About the position Responsibilities • Independently collaborates effectively with ED and outpatient care teams to establish an individualized transition plan for members. • Serves as the clinical liaison with hospital, clinical and administrative staff, performing transition of care/care coordination for ED discharges using evidence-based criteria. • Performs expedited, standard, concurrent, and retrospective clinical reviews at in-network and/or out-of-network facilities. • Interacts and communicates effectively with ED staff, members, and their families to assess discharge needs and formulate discharge plans. • Identifies member's ED discharge support opportunities and level of risk by monitoring real-time ADT feeds. • Conducts transition of care outreach following ED discharge to confirm access and completion of discharge plans. • Manages assigned case load efficiently utilizing time management skills. • Demonstrates knowledge of utilization management and care coordination processes for transition planning activities. • Enters timely and accurate documentation into designated care management applications to comply with documentation requirements. • Adheres to organizational and departmental policies and procedures. • Takes on-call assignments as directed. Requirements • Current, unrestricted Multistate RN license. • 4+ years of diverse clinical experience in caring for acutely ill patients with multiple disease conditions. • Knowledge of utilization management, quality improvement, and discharge planning. • Proficient in Microsoft Office applications including Outlook, Word, and Excel. • Ability to read, analyze, and interpret information in medical records and health plan documents. • Demonstrated problem-solving skills and ability to identify community resources. • Proven planning, organizing, conflict resolution, negotiating, and interpersonal skills. • Ability to utilize critical thinking skills, nursing judgment, and decision-making skills. • Proven ability to prioritize, plan, and handle multiple tasks/demands simultaneously. Nice-to-haves • Experience working in the Emergency Department. • Experience with managed care and/or case management. Benefits • Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution Apply tot his job Apply To this Job