Care Manager, RN


  • The Nurse Case Manager (CM) is responsible for care coordination of patients along their continuum from point of entry through discharge. The CM will address issues related to appropriate and timely admission, discharge, and care for patients receiving inpatient and observation care and services at PPHS facilities. The Care Manager performs first level clinical reviews according to hospital approved clinical criteria and in accordance with the Care Management Program's Utilization Plan and payer specific requirements. He/she will address utilization of resources for efficient and effective care delivery at the appropriate level of care. The Care Manager collaborates with social work, physicians, nurses and multidisciplinary team, lending professional care management expertise to ensure quality, timely and cost effective case management for an identified patient population and addresses issues or patterns in patient readmission. In this role the Care Manager is accountable for facilitating clinical patient progression through a defined plan of care to achieve optimal outcomes. Under the direction of the Care Management Team Lead, the Director of Care Management, and through coordination with nursing, social work, physicians and other members of the interdisciplinary team, the Care Manager develops, facilitates and implements appropriate case management and discharge plans.
  • Adheres to the hospital and departmental attendance and punctuality guidelines
  • Performs all job responsibilities in alignment with the core values, mission and vision of the organization
  • Performs other duties as required and completes all job functions as per departmental policies and procedures
  • Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs)
  • Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
  • Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills.
  • Wears protective clothing and equipment as appropriate.
  • General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.
  • May be exposed to high noise levels and bright lights.
  • May be exposed to limited hazardous substances or body fluids, or infectious organisms.
  • May be required to change from one task to another of different nature without loss of efficiency or composure.
  • Periods of high stress and fluctuating workloads may occur.
  • May be scheduled as needed including overtime


  • 2 year / Associate Degree in Nursing from a state accredited school (Required)
  • 4 year / Bachelor's Degree in from a state accredited School of Professional Nursing (Preferred)
  • 2 - 3 years recent acute care experience with relevant clinical experience in the assigned area. (Required)
  • 1 - 2 years Case management or utilization review experience in a hospital or related setting (Preferred)
  • Required Certifications/Licensures: Registered Nurse (RN) with current Georgia license
  • Preferred Certifications/Licensures: Certified Case Manager (CCM)
  • Organizational Skills
  • Communication Skills
  • Interpersonal Skills
  • Customer Relations
  • Mathematical
  • Analytical
  • Grammar / Spelling
  • Read / Comprehend Written Instructions
  • Follow Verbal Instructions
  • Basic Computer Skills
  • General Clerical Skills
  • Maintains knowledge of current federal, state and accreditation requirements applicable to utilization review and discharge planning; demonstrates skill in the application of this knowledge
  • Demonstrates sound critical thinking, judgement and problem solving skills
  • Demonstrates ability to prioritize assignment and issues to effectively manage case load or projects
  • Fosters and demonstrates teamwork with an ability to work collaboratively with social work staff and the interdisciplinary team.
  • Have near normal vision - Clarity of vision (both near and far), ability to distinguish colors
  • Have good - manual dexterity and eye-hand-foot coordination
  • Ability to perform - repetitive tasks/motion
  • Standing - Continuously within shift (67-100%)
  • Walking - Frequently within shift (34-66%)
  • Sitting - Occasionally within shift (1-33%)
  • Climbing - Occasionally within shift (1-33%)
  • Bending/Stooping - Frequently within shift (34-66%)
  • Twist at waist - Occasionally within shift (1-33%)
  • Pushing/Pulling - Frequently within shift (34-66%)
  • Reaching above shoulder - Occasionally within shift (1-33%)