Description

Job Description

Overview

Location: University Hospital

Shift: 1.0 FTE Mon-Fri 8a-4:30p

Position: RN - Case Manager

IU Health University Hospital is dedicated to delivering high-quality patient care through effective care coordination and seamless transitions across care settings. We are seeking a passionate and experienced RN to join our team as a Case Manager, responsible for planning and coordinating patient care from admission through post-discharge.

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Position Overview:

The RN-Case Manager plays a vital role in ensuring smooth patient transitions across various care environments. This position involves assessing patient needs, coordinating multidisciplinary care, and communicating with patients, families, providers, and payers to optimize outcomes and resource utilization. The nurse collaborates closely with the care team to develop individualized discharge plans, manage insurance coverage, and administer education and prevention programs.

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Key Responsibilities:

Plan and coordinate patient care from admission through post-discharge, ensuring appropriate levels of care and services.

• Perform accurate and timely discharge planning, including documentation and communication.

• Collaborate with the multidisciplinary team to develop comprehensive, individualized care plans.

• Work with third-party payers to verify coverage, obtain authorizations, and support appeals.

• Educate patients and families on post-discharge care, safety, and prevention strategies.

• Assist with third-party denials, appeals, and understanding contractual arrangements.

• Ensure compliance with Medicare, Medicaid, insurance, and regulatory guidelines.

• Utilize various software applications including Windows, Cerner, and SMS for documentation and communication.

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Qualifications & Requirements:

• Education:

- Associate's Degree in Nursing required.

- New ASN RNs hired after January 1, 2013, will be required to complete their BSN within 5 years of hire date.

• Licensure:

- Active RN license in Indiana or Nurse Licensure Compact (NLC).

• Certifications:

- Case Management certification preferred.

• Experience:

- 3-5 years of clinical experience in acute care required.

• Knowledge & Skills:

- Familiarity with Medicare/Medicaid, insurance policies, and regulatory requirements is advantageous.

- Ability to understand third-party contractual arrangements and the denial/appeal process is a plus.

- Proficiency with Windows, Cerner, SMS, and other relevant software applications.

- Strong clinical background with excellent assessment and communication skills.

- Knowledge of InterQual Acute Level of Care Criteria and federal coverage guidelines preferred.

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Why IU Health University Hospital?

As part of Indiana's largest and most comprehensive healthcare system, we offer:

• Competitive salary and comprehensive benefits

• Opportunities for professional development and growth

• A collaborative, innovative environment dedicated to excellence

To learn more about our benefits, visit: careers.iuhealth.org/pages/benefits-designed-for-you

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Join IU Health!

Be part of Indiana's leading healthcare system committed to delivering exceptional patient care, effective care coordination, and innovative discharge planning. We provide professional growth opportunities, a collaborative environment, and meaningful work that makes a difference.

Ready to lead seamless patient transitions? Apply today to become an RN - Case Manager at IU Health University Hospital!

We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.