Case Manager RN PRN

DescriptionStep into a meaningful role at Logan Regional Medical Center, a 132-bed facility located in southern West Virginia. Logan Regional is an award-winning, full-service community hospital with a history of innovation, from its one-of-a-kind Rural General Surgery residency program to its collaboration with Marshall Health Network to bring more opportunities for specialty care to the area. Logan Regional has earned the prestigious "A" grade from The Leapfrog Group, inclusion in Becker’s listing of Great Community Hospitals, Forbes Inaugural Top Hospitals list, and Best-in-State hospital status from Newsweek/Statista. Consider growing your career at Logan Regional, which offers an ideal combination of high standards of care in a small, caring community.Job SummaryThe RN–Case Manager is responsible for assessing, planning, coordinating, and monitoring the healthcare services and resources necessary to meet the individual needs of patients. This role ensures effective case management processes that promote optimal patient outcomes, quality of care, regulatory compliance, and cost efficiency across the continuum of care.Essential FunctionsReviews clinical documentation and coordinates care across departments to ensure medically necessary services are provided in a timely and cost-effective mannerPerforms discharge planning by identifying patient needs and arranging post-discharge services including home health, medical equipment, and rehabilitationCollaborates with interdisciplinary team members, physicians, patients, and families to support quality care and safe transitionsCommunicates with insurance providers and payers for authorization and continued stay approvalsDocuments all activities, decisions, communications, and patient education in the EMRParticipates in performance improvement initiatives, utilization review, and data collection efforts for administrative reportingConducts 48-hour post-discharge follow-up calls as applicableAdvocates for the patient and serves as a liaison between healthcare providers, patients, families, and community resourcesAssists with readmission assessments and care coordination strategiesKeeps current with Medicare/Medicaid rules, CMS guidelines, and payer requirementsKnowledge/Skills/Abilities/ExpectationsAdvanced understanding of case management principles, patient advocacy, and discharge planningStrong critical thinking, time management, and problem-solving skillsExcellent interpersonal and communication abilitiesFamiliarity with utilization management, payer authorization processes, and EMR systemsCapacity to work independently and collaboratively in a high-pressure environmentCommitment to maintaining patient confidentiality and upholding ethical standardsAbility to prioritize multiple responsibilities and adjust to changes in work schedule or patient needsQualificationsEducationAssociate Degree in Nursing, requiredBachelor of Science in Nursing (BSN), preferredLicenses/CertificationsCurrent and valid Registered Nurse license in the state of practice or Compact State RN licenseBasic Life Support (BLS) – required within time frame specified in facility policyAccredited Case Manager (ACM) Certification as required by facility policyExperienceMinimum of 1-2 years of clinical experience in an acute hospital, clinic, home health, hospice, or mental health facility, requiredPrevious case management experience preferred