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Case Management Rn Jobs in Wisconsin (NOW HIRING)

Hospice Alliance

RN CASE MANAGER

Pleasant Prairie, WI · On-site

The RN Case Manager is responsible for identifying and coordinating patient/family care to support ... case management. * Evaluate and perform ongoing assessments and revise initial written plan of care ...

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Case Management Rn information

How to work in case management as a nurse?

To work as a case management RN, obtain a nursing license and relevant experience in patient care. Develop skills in care coordination, documentation, and communication, and consider earning certifications such as the Certified Case Manager (CCM). Familiarity with electronic health records (EHR) systems and understanding healthcare policies are also important for success in this role.

What is the difference between Case Management Rn vs Discharge Planner?

AspectCase Management RnDischarge Planner
CredentialsRegistered Nurse (RN), often with certifications in case managementRegistered Nurse (RN), often with experience in discharge planning
Work EnvironmentHospitals, clinics, insurance companies, community healthHospitals, rehabilitation centers, skilled nursing facilities
Primary FocusCoordinating patient care, managing resources, ensuring continuity of carePlanning patient discharge, coordinating post-hospital care, ensuring safe transition

While both roles involve patient care coordination, Case Management Rns have a broader scope, managing ongoing care plans across settings, whereas Discharge Planners focus specifically on preparing patients for discharge and arranging follow-up services.

What does a RN case manager do?

An RN case manager coordinates patient care by assessing health needs, developing care plans, and ensuring appropriate services are provided. They work with healthcare teams, document patient progress, and often use electronic health records to track outcomes, requiring strong communication and organizational skills.

Is being a RN case manager worth it?

A registered nurse (RN) case manager plays a key role in coordinating patient care, often working in healthcare settings or insurance companies. The position typically offers competitive salaries, opportunities for specialization, and the chance to improve patient outcomes, making it a valuable career choice for those interested in clinical and administrative aspects of nursing.

What are some common challenges that Case Management RNs face when coordinating care across multiple healthcare providers?

Case Management RNs often encounter challenges such as communication barriers between different healthcare teams, variations in care protocols, and delays in information sharing. Navigating insurance requirements and ensuring all providers are aligned with the patient’s care plan can also be demanding. Strong organizational and interpersonal skills are essential to address these challenges and advocate effectively for patients while maintaining efficient transitions of care.

Do RN case managers make more than floor nurses?

RN case managers typically earn higher salaries than floor nurses because they have additional responsibilities such as coordinating patient care, managing treatment plans, and often require specialized certifications. Salary differences can vary based on experience, location, and healthcare setting, but case management roles generally offer higher compensation due to the increased scope of work.

What is a Case Management RN?

A Case Management RN (Registered Nurse) is a nursing professional who coordinates patient care across various healthcare settings to ensure efficient and effective treatment. They assess patient needs, develop care plans, facilitate communication between patients, families, and healthcare providers, and help manage resources to achieve optimal health outcomes. Case Management RNs often focus on helping patients navigate complex medical systems, making sure they receive appropriate services and support throughout their healthcare journey.

What are the key skills and qualifications needed to thrive as a Case Management RN, and why are they important?

To thrive as a Case Management RN, you need a solid nursing background, case management experience, and an active RN license, often accompanied by certifications like CCM or ACM. Familiarity with case management software, electronic health records (EHR), and utilization review systems is crucial for efficiency. Strong communication, problem-solving, and organizational skills help build rapport with patients and coordinate multidisciplinary care. These competencies ensure effective care planning, optimal patient outcomes, and efficient resource utilization within healthcare settings.
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Case Management Rn jobs near you
Director of Case Management

Director of Case Management

Champion Care

Milwaukee, WI

Full-time

Posted 23 days ago

Job description

Director of Case Management (LPN/RN)Skilled Nursing & Post-Acute Care | Full-Time

Champion Care is seeking an experienced and highly organized Director of Case Management to oversee clinical case management operations across our skilled nursing and post-acute care facilities. This leadership role is ideal for an experienced LPN or RN with strong MDS, Medicare, managed care, and reimbursement knowledge who understands the critical connection between clinical documentation, payer management, length of stay, and financial performance.

The Director of Case Management will partner closely with facility leadership, MDS teams, admissions, therapy, and business office personnel to optimize reimbursement, improve authorization outcomes, support census growth, and ensure exceptional resident care throughout the post-acute stay.

If you have a background as an MDS Coordinator, Regional MDS Nurse, Case Manager, Clinical Reimbursement Specialist, Managed Care Coordinator, or Director of Case Management, we encourage you to apply.

Key Responsibilities
  • Lead and oversee case management operations across multiple skilled nursing facilities.
  • Provide guidance and support to facility MDS Coordinators and clinical teams regarding reimbursement and payer requirements.
  • Monitor and manage insurance authorizations, concurrent reviews, updates, extensions, and appeals.
  • Review MDS processes and documentation to support accurate reimbursement and regulatory compliance.
  • Collaborate with admissions teams to evaluate referrals and optimize payer opportunities.
  • Monitor Medicare, Medicaid, Managed Care, and commercial insurance utilization.
  • Analyze length of stay trends, denial patterns, and reimbursement opportunities.
  • Partner with therapy, nursing, and interdisciplinary teams to ensure appropriate clinical documentation.
  • Support discharge planning efforts and transitions of care.
  • Assist facilities with complex payer issues, authorization challenges, and reimbursement concerns.
  • Conduct audits and provide education related to case management, reimbursement, and managed care processes.
  • Track key performance indicators and develop action plans to improve outcomes.
  • Participate in weekly reimbursement, Medicare, and managed care review meetings.
  • Ensure compliance with federal, state, and payer-specific regulations.
  • Assist with training, onboarding, and development of facility-based case management and MDS staff.
Qualifications
  • Current LPN or RN license required.
  • MDS experience in a skilled nursing facility setting required.
  • Previous experience as an MDS Coordinator, Case Manager, Clinical Reimbursement Specialist, or similar role preferred.
  • Strong understanding of Medicare, Medicaid, PDPM, Managed Care, and post-acute reimbursement processes.
  • Skilled nursing facility experience required.
  • Ability to analyze clinical and financial data to identify reimbursement opportunities.
  • Strong leadership, communication, and organizational skills.
  • Ability to manage multiple priorities and support multiple facilities.
  • Experience working collaboratively with admissions, therapy, nursing, and business office teams.
Why Join Champion Care
  • Competitive salary based on experience.
  • Paid time off
  • Company-paid health, dental, and vision insurance.
  • Industry-leading bonus program.
  • Opportunity to support and influence multiple facilities across a growing healthcare organization.
  • Collaborative leadership team and strong operational support.
  • Significant opportunities for professional growth and advancement.

Champion Care is an Equal Opportunity Employer (EOE). We are committed to creating an inclusive workplace for all employees and applicants and do not discriminate based on race, color, religion, sex, national origin, age, disability, genetic information, or any other protected status.

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