Case Manager
Location: Can live in Casper or Douglas WY, will support both, (relocation assistance will be provided)
Description
The Case Manager coordinates all authorizations and reauthorizations for patient services, identifies care needs for safe and appropriate discharge planning, ensures compliance with third-party payers, and acts as Utilization Review liaison with Health Information Management (HIM).
Requirements
Registered Nurse or a Social Worker
Master of Social Work or current WY RN license or a in social work
Two to three years' experience in hospital setting preferred
Experience with hospital, SNF, and health plan-based case management systems preferred
BLS required
Job Summary
We are seeking a dedicated and experienced Case Manager with Registered Nurse (RN) or Master of Social Work (MSW) credentials to join our dynamic healthcare team in Wyoming. This role is pivotal in coordinating comprehensive patient care, facilitating seamless transitions across various care settings, and ensuring optimal health outcomes. The ideal candidate will possess a strong background in acute and post-acute care, with expertise in managing complex cases within diverse medical environments. Relocation assistance is available to support qualified applicants in joining our organization and making a meaningful impact on patient lives. Key Responsibilities:
- Conduct thorough patient assessments, including vital signs and physiological evaluations, to develop individualized care plans.
- Coordinate discharge planning, ensuring timely and appropriate transfer of patients to post-acute or outpatient settings.
- Manage utilization review and case management processes to optimize resource use and maintain compliance with healthcare policies.
- Collaborate with multidisciplinary teams—including physicians, nurses, social workers, and specialists—to facilitate comprehensive patient care.
- Maintain accurate medical records, documentation, and medical terminology entries in compliance with HIPAA regulations.
- Oversee diagnostic evaluations, medical records review, and patient service coordination to support effective treatment plans.
- Engage in intake procedures for new patients, assessing needs and establishing appropriate care pathways.
- Support hospital experience initiatives by providing case management for inpatient and outpatient populations across various specialties such as ICU, PICU, Geriatrics, Behavioral health, Emergency medicine, and Infectious disease care.
- Participate in quality improvement activities related to hospital medicine, trauma centers (Level I & II), and other specialized units.
- Assist with outpatient clinic operations by managing patient assessments and facilitating continuity of care. Skills:
- Proven experience in critical care environments such as ICU, PICU, or emergency room settings.
- Familiarity with Level I Trauma Centers and Level II Trauma Center protocols.
- Strong knowledge of hospital medicine practices, including acute care procedures and inpatient management.
- Experience with managed care processes, utilization management, and discharge planning.
- Excellent patient assessment skills combined with a solid understanding of physiology and medical terminology.
- Ability to navigate electronic medical records efficiently while maintaining HIPAA compliance.
- Competence in diagnostic evaluation techniques and post-acute care coordination.
- Effective communication skills tailored for diverse patient populations across inpatient and outpatient settings.
- Knowledge of behavioral health considerations within hospital or clinic environments.
- Ability to work collaboratively within multidisciplinary teams to deliver high-quality patient service. Join our team as a Case Manager – RN/MSW in Casper or Douglas, WY where your expertise will directly influence patient outcomes through compassionate care coordination. We value professionalism, dedication, and the drive to improve healthcare delivery across all levels of service.
Pay: $75,000.00 - $100,000.00 per year
Benefits:
Work Location: On the road
