Salary Not Available
Position range in Naples-Marco Island, FL Metropolitan Statistical Area $81k - $106k Per Year
RN Case Manager
NCH Healthcare System
Occupation: Registered Nurses
Location: Naples, FL - 34102
Positions available: 1
Job #: 2321
Source: NCH Healthcare System
Posted: 7/23/2025
Web Site: nchmd.org
Job Type: Full Time (30 Hours or More)
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Job Requirements and Properties
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Work Onsite
Full Time
Schedule
Full Time
Job Description Help for Job Description. Opens a new window.
Job Description
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JOB SUMMARY
The RN Case Manager serves as a patient advocate to support, guide and coordinate care for patients, families, and caregivers as they navigate their health and wellness journeys. The RN Case Manager is responsible for participating in the development of the patient's plan of care and facilitating efficient throughput, ensuring appropriate utilization of resources, identifying needs, and establishing safe and appropriate discharge plans.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Other duties may be assigned.
Screen all patients for clinical, psychosocial, financial, and other factors that may affect the progression of care and collaborate with patients/families/caregivers in goal setting that is reflective of the patient's needs.
Evaluates the patient's/family's/caregiver's level of understanding and engagement with the progress toward goals and incorporates findings into the plan of care.
Arranges services among community agencies, provider, patient/family/caregivers, and others involved in the plan of care.
Provides patient/family/caregivers available tools/ resources including pertinent quality measures to make informed choices.
Develops a plan that is clinically appropriate and focused on the patient's care needs and goals for care and treatment plan is consistent with patient choice and available resources.
Facilitate bi-directional communication to enhance the handover of care from one setting and arrange/ensure all elements of the transition plan are implemented and communicated to key stakeholders including, not limited to, the health care team, patient/family/caregiver, payers, and post-acute providers.
Identify available community resources/potential partners and advocate for resolution of gaps in the available resources and processes.
Maintain knowledge of and ensure compliance with the federal, state, local organization and accreditation requirements that not only impact their scope of services but affect their ability to advocate for the patient.
Ensure the patient is in the appropriate status, level of care and length of stay for the patient's clinical condition and participates in multidisciplinary rounds with the care team.
Follows through with appropriate intervention and documentation to facilitate discharge when a patient fails to meet medical necessity.
Identify and address avoidable delay practice patterns that may require modification to support cost-effective care. Uses escalation process as needed.
Educates patients/families/caregivers on the financial impact of their care options.
Tracks avoidable delays/days as well as over/under utilization of resources.
Provide the clinical information necessary for the appeals process of cases for which a denial of care or services has been received.
Proactively prevent medical necessity denials by providing education to physicians, staff and patients, interfacing with payers and documenting relevant information.
Participate in the development of performance improvement activities relevant to identified opportunities.
Actively collaborates with utilization review team to facilitate and meet organizational and department goals.
Recognizes situations that require referral to quality or risk management and makes a timely referral.
Additional Information Help for Additional Information. Opens a new window.
Additional Information
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EDUCATION, EXPERIENCE AND QUALIFICATIONS Minimum of Associate Degree in Nursing required; BSN preferred. Minimum of 1 years Discharge planning, case management, managed care, or Registered Nurse experience in a medical setting. Licensed as a Registered Nurse (RN) in the state of Florida. Basic Life Support (BLS) certification required from the American Red Cross or American Heart Association. Case Management Certification preferred.
Help for Employer Information. Opens a new window.
Position range in Naples-Marco Island, FL Metropolitan Statistical Area $81k - $106k Per Year
RN Case Manager
NCH Healthcare System
Occupation: Registered Nurses
Location: Naples, FL - 34102
Positions available: 1
Job #: 2321
Source: NCH Healthcare System
Posted: 7/23/2025
Web Site: nchmd.org
Job Type: Full Time (30 Hours or More)
Job Requirements and Properties Help for Job Requirements and Properties. Opens a new window.
Job Requirements and Properties
Help for Job Requirements and Properties. Opens a new window.
Work Onsite
Full Time
Schedule
Full Time
Job Description Help for Job Description. Opens a new window.
Job Description
Help for Job Description. Opens a new window.
JOB SUMMARY
The RN Case Manager serves as a patient advocate to support, guide and coordinate care for patients, families, and caregivers as they navigate their health and wellness journeys. The RN Case Manager is responsible for participating in the development of the patient's plan of care and facilitating efficient throughput, ensuring appropriate utilization of resources, identifying needs, and establishing safe and appropriate discharge plans.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Other duties may be assigned.
Screen all patients for clinical, psychosocial, financial, and other factors that may affect the progression of care and collaborate with patients/families/caregivers in goal setting that is reflective of the patient's needs.
Evaluates the patient's/family's/caregiver's level of understanding and engagement with the progress toward goals and incorporates findings into the plan of care.
Arranges services among community agencies, provider, patient/family/caregivers, and others involved in the plan of care.
Provides patient/family/caregivers available tools/ resources including pertinent quality measures to make informed choices.
Develops a plan that is clinically appropriate and focused on the patient's care needs and goals for care and treatment plan is consistent with patient choice and available resources.
Facilitate bi-directional communication to enhance the handover of care from one setting and arrange/ensure all elements of the transition plan are implemented and communicated to key stakeholders including, not limited to, the health care team, patient/family/caregiver, payers, and post-acute providers.
Identify available community resources/potential partners and advocate for resolution of gaps in the available resources and processes.
Maintain knowledge of and ensure compliance with the federal, state, local organization and accreditation requirements that not only impact their scope of services but affect their ability to advocate for the patient.
Ensure the patient is in the appropriate status, level of care and length of stay for the patient's clinical condition and participates in multidisciplinary rounds with the care team.
Follows through with appropriate intervention and documentation to facilitate discharge when a patient fails to meet medical necessity.
Identify and address avoidable delay practice patterns that may require modification to support cost-effective care. Uses escalation process as needed.
Educates patients/families/caregivers on the financial impact of their care options.
Tracks avoidable delays/days as well as over/under utilization of resources.
Provide the clinical information necessary for the appeals process of cases for which a denial of care or services has been received.
Proactively prevent medical necessity denials by providing education to physicians, staff and patients, interfacing with payers and documenting relevant information.
Participate in the development of performance improvement activities relevant to identified opportunities.
Actively collaborates with utilization review team to facilitate and meet organizational and department goals.
Recognizes situations that require referral to quality or risk management and makes a timely referral.
Additional Information Help for Additional Information. Opens a new window.
Additional Information
Help for Additional Information. Opens a new window.
EDUCATION, EXPERIENCE AND QUALIFICATIONS Minimum of Associate Degree in Nursing required; BSN preferred. Minimum of 1 years Discharge planning, case management, managed care, or Registered Nurse experience in a medical setting. Licensed as a Registered Nurse (RN) in the state of Florida. Basic Life Support (BLS) certification required from the American Red Cross or American Heart Association. Case Management Certification preferred.
Help for Employer Information. Opens a new window.
Job ID: 486664350
Originally Posted on: 7/24/2025
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