Job Description

Care Manager – Inpatient (RN)

Job Summary

The Inpatient Care Manager (RN) coordinates care and services for selected patient populations to ensure a safe, timely, and effective transition to the next appropriate level of care. This role is responsible for conducting clinical assessments, developing care plans, implementing services, coordinating care, monitoring outcomes, and evaluating the effectiveness of services to meet patients’ clinical, psychosocial, and financial needs. The Care Manager collaborates closely with the interdisciplinary healthcare team to support optimal clinical outcomes, efficient resource utilization, and reduced readmissions.

Essential Duties & Responsibilities

• Develops and maintains a comprehensive case management plan by reviewing clinical findings, diagnostic results, and patient assessments in collaboration with physicians and the care team.
• Identifies high-risk patients requiring psychosocial intervention and refers appropriately to social services.
• Conducts assessments and implements proactive interventions to prevent avoidable readmissions; evaluates readmission causes and develops prevention strategies.
• Develops, documents, and coordinates discharge and transition-of-care plans in collaboration with the interdisciplinary team, adjusting plans as patient needs evolve.
• Communicates and escalates payer or financial issues that may impact post-acute care planning.
• Monitors patient length of stay (LOS), participates in care rounds, and works proactively with the clinical team to address barriers to discharge.
• Coordinates transitions of care across the continuum by communicating effectively with patients, families, physicians, utilization review staff, and care team members.
• Maintains working knowledge of federal, state, and regulatory requirements, including CMS, Medicare, Joint Commission standards, Observation status, the Two-Midnight Rule, and Medicare Inpatient-Only procedures.
• Provides education to patients, families, and staff regarding care progression, appropriate levels of care, service utilization, and safe transitions.
• Identifies potential quality, risk management, or compliance issues and escalates through appropriate channels when needed.

Required Skills & Experience

• Strong communication, negotiation, and conflict-resolution skills.
• Proficiency with clinical documentation systems and data analysis tools.
• Knowledge of state and federal regulatory standards related to inpatient case management.
• Experience with clinical performance improvement or rapid cycle change initiatives.
• Prior clinical experience caring for hospitalized patients.

Preferred Skills & Experience

• Previous experience in acute care case management.
• Formal case management training or certification through a recognized professional organization.

Schedule & Duration

• Start Date: January 19, 2026
• Estimated End Date: March 14, 2026
• Hours: 40 hours per week
• Schedule: Monday–Friday, 8:00 AM – 4:00 PM
• No weekends or on-call requirements

Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

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