RN Admissions Case Manager – Concurrent and ED

This is a fully remote position, open to applicants in Louisiana.

📋 Description

• Assess psychosocial, environmental, familial, and economic factors impacting patients.

• Verify care settings as per physician orders and implement hospital-sanctioned medical necessity criteria.

• Evaluate admissions, levels of care, and ongoing hospital stays.

• Log completed evaluations in the hospital-approved data repository.

• Engage in discussions regarding alternative care options with emergency department, admitting, and attending physicians.

• Act as a liaison and communicator among patients, caregivers, multidisciplinary teams, post-acute care providers, and third-party payers.

• Conduct pre-admission, admission, and ongoing stay procedures.

• Sustain open lines of communication with relevant parties.

• Manage the planning of patient transitions through the healthcare system.

• Collaborate with managed-care and third-party payers to secure financial certification, ensure proper reimbursement, and reduce denials.

• Oversee the care of assigned patients throughout the healthcare system according to their unique needs.

• Ensure compliance with relevant laws, accreditation standards, and regulatory mandates.

• Report any suspected unethical behavior, safety concerns, privacy issues, or compliance-related matters.

⛳️ Requirements

• Diploma in Nursing or an equivalent qualification.

• Minimum of 1 year of experience in a hospital setting providing patient care.

• Valid RN License in the state of practice.

• Experience working both independently and collaboratively within a team environment.

• Ability to respond positively to change and maintain composure in high-pressure situations.

• Knowledge of business and financial aspects, along with an understanding of healthcare delivery systems.

• Proficient computer skills, including data entry and retrieval of patient information.

• Familiarity with Windows-style applications and keyboard operations.

• Strong verbal and written communication abilities.

• Excellent skills in conflict resolution.

• Capacity to work a flexible schedule, including 24/7 availability, weekends, holidays, and on-call duties.

• Physical ability to stoop, bend, reach, grab, and sit for extended durations.

• Capability to work in a patient-care setting with potential exposure to blood, body fluids, tissues, communicable diseases, hazardous medications, and waste.

🏝️ Benefits

• Commitment to equal opportunity employment and consideration without regard to legally protected characteristics.

• Provision of reasonable accommodations for qualified individuals with disabilities.

• Support for accessibility and application accommodations.