RN Case Manager
Position Summary
The Clinical Coordinator/Case Manager serves in a dual-capacity role, dedicating approximately 50% of time to clinical coordination and department operations and 50% of time to direct patient case management activities. This position supports the coordination and oversight of care management processes while maintaining an active caseload to ensure high-quality, patient-centered care across the continuum.
As a Clinical Coordinator, the incumbent provides day-to-day operational support, assists with workflow management, staff onboarding and education, quality initiatives, compliance monitoring, and serves as a resource to the interdisciplinary team. The role promotes adherence to regulatory requirements, organizational policies, and best practices in care coordination and utilization management.
As a Case Manager, the incumbent conducts patient assessments, develops and implements individualized discharge plans, coordinates transitions of care, collaborates with physicians and interdisciplinary team members, and advocates for patients to ensure appropriate utilization of resources and timely progression of care. The role focuses on achieving optimal clinical, financial, and patient satisfaction outcomes while supporting safe and effective care transitions.
This position requires strong clinical judgment, leadership skills, effective communication, and the ability to balance operational responsibilities with direct patient care coordination in a fast-paced healthcare environment.
Responsibilities
- Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as:
- MCG- Milliman Care Guidelines
- R1- Physician Advisor
- Payer Portal Administrator
- Coordinate all aspects of new hire orientation including (not all inclusive):
- Development of Orientation Calendar
- Assignment of Preceptors
- Hardware/ Software Needs and Accesses
- Preceptor/ Preceptee Documentation-Support
- Develop/ Maintain New Hire Orientation Manuals
- Develop/ Ensure Annual Case Management Competencies
- MCG: Interrater Reliability
- MCG LMS Coursework
- DNV/JC Case Management Competencies
- Collaborate with Health System Clinical Coordinators
- Develop and Maintain Case Management Education Calendar
- Design and Facilitate Education surrounding EPIC upgrades/ changes.
- Facilitate clinical education on current best practices
- Develop/ Maintain CM Database with all CM related education/ resources
- Serve as Expert/ Maintain knowledge of all CM related functions and workflows including:
- Utilization Review
- Denials/ Appeals Management
- Discharge Planning
- Medicare Compliance
- Mental Health/ Substance Use
- Readmission Reduction
- Perform all duties as assigned in Case Management Role
Requirements
- Current R.N. licensure in Ohio (must be maintained)
- 2 years active Acute Case Management Experience
- Obtain Case Management Certification within one year of employment in role
- Current CPR card and maintain.
- Maintain knowledge of new technology and equipment
- Ability to work independently.
- Successful candidate must have excellent critical thinking skills.
- LMH is accredited by DNV and TJC, and as such, may require specific annual education related to specialty certifications and standards.
Licking Memorial Health Systems is an equal opportunity employer and maintains compliance with all state, federal, and local regulations. Licking Memorial Health Systems does not discriminate against applicants because of race, color, religion, sex, sexual orientation, age, ancestry, national origin, veteran status, pregnancy, disability, marital status, or other characteristics protected by law.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.
