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Medicare Rn Jobs in Nebraska (NOW HIRING)

Bryan Health

Care Transitions RN

Lincoln, NE · On-site

The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and ... Serves as an internal and external resource regarding Medicare/Medicaid rules, regulations and ...

Healogics

Clinical Nurse Manager - RN

Norfolk, NE

... Medicare and Medicaid Services (CMS) guidelines, as applicable. Essential Functions ... Current RN (Registered Nurse) license - to maintain throughout the duration of employment in the ...

Healogics

Clinical Nurse Manager - RN

Norfolk, NE · On-site

... Medicare and Medicaid Services (CMS) guidelines, as applicable. Essential Functions ... Current RN (Registered Nurse) license - to maintain throughout the duration of employment in the ...

Humana

$71K - $87K/yr

... Medicare/Medicaid members. Position Responsibilities: * The RN Field Care Manager will be ... responsible for managing a caseload and completing assessments with members in their home or ...

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Medicare Rn information

What does a Medicare RN do?

A Medicare RN is a registered nurse who specializes in providing care and managing cases for patients covered under Medicare, the federal health insurance program for people 65 and older or with certain disabilities. Their duties often include patient assessments, developing care plans, coordinating services, ensuring compliance with Medicare regulations, and educating patients and families about their healthcare options. They may work in hospitals, home health agencies, or long-term care facilities, helping to optimize patient outcomes while ensuring proper documentation for Medicare reimbursement.

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

To thrive as a Medicare RN, you need a comprehensive understanding of clinical nursing practices, Medicare regulations, and care coordination, typically supported by an active RN license and experience in case management or utilization review. Familiarity with Medicare documentation requirements, electronic health records (EHRs), and case management software is essential. Strong communication, attention to detail, and critical thinking skills help Medicare RNs effectively advocate for patients and collaborate with healthcare teams. These skills ensure compliance with regulations, optimize patient outcomes, and support efficient healthcare delivery within the Medicare system.

What are the typical challenges Medicare RNs face when coordinating patient care across multiple providers?

Medicare RNs often encounter challenges related to coordinating care among various healthcare providers, such as physicians, specialists, and home health agencies. Navigating different documentation systems and ensuring timely communication can be complex, especially when managing patients with multiple chronic conditions. Effective organization, strong communication skills, and a thorough understanding of Medicare guidelines are essential for overcoming these challenges and providing seamless care transitions.

What is the difference between Medicare Rn vs Home Health Nurse?

AspectMedicare RnHome Health Nurse
CredentialsRegistered Nurse license, Medicare certificationRegistered Nurse license, home health certification
Work EnvironmentHospitals, clinics, Medicare facilitiesPatients' homes, community settings
Employer & IndustryMedicare providers, healthcare agenciesHome health agencies, hospice services
Search & Comparison IntentMedicare Rn vs Home Health NurseMedicare Rn vs Home Health Nurse

Both Medicare Rns and Home Health Nurses are registered nurses working within the Medicare system. While Medicare Rns often work in clinics or hospitals providing Medicare-related care, Home Health Nurses focus on delivering nursing services directly in patients' homes. Both roles require RN licensure, but their work environments and employer types differ, reflecting their specific patient care settings.

What are popular job titles related to Medicare Rn jobs in Nebraska?

For Medicare Rn jobs in Nebraska, the most frequently searched job titles are:

What job categories do people searching Medicare Rn jobs in Nebraska look for?

The top searched job categories for Medicare Rn jobs in Nebraska are:

What cities in Nebraska are hiring for Medicare Rn jobs?

Cities in Nebraska with the most Medicare Rn job openings:

Medicare Rn jobs near you
Infographic showing various Medicare Rn job openings in Nebraska as of August 2026, with employment types broken down into 80% Full Time, 16% Part Time, and 4% Contract. Highlights an 92% In-person, and 8% Remote job distribution.

Care Transitions RN

Bryan Health

Lincoln, NE • On-site

Full-time

Re-posted 7 days ago

Bryan Health rating

7.1

Company rating: 7.1 out of 10

Based on 119 frontline employees who took The Breakroom Quiz

382nd of 891 rated healthcare providers

Job description

GENERAL SUMMARY:
The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and utilization coordination of the patient's hospital experience. Proactively consults with the interdisciplinary team which includes but is not limited to hospital patient care staff, physicians, patient support and family and community resources to assure a smooth transition for the patient through appropriate levels of care in order to facilitate quality outcomes.
PRINCIPAL JOB FUNCTIONS:
*Commits to the mission, vision, beliefs and consistently demonstrates our core values.
*Utilizes clinical skills to create and update personalized transitional care plans for patients.
*Performs transition planning activities at onset and throughout the patient's hospitalization.
*Collaborates with the patient's provider and other healthcare team members in managing the patient's length of stay and determining the appropriate level of care for transition planning.
*Assists in identifying need for supportive counseling or post discharge extended psychosocial therapy and consults with attending Physician for referral to appropriate provider.
*Maintains awareness of financial reimbursement methodology, utilization management, payer/reimbursement practices and regulations and participates in resource stewardship.
*Promotes quality improvement initiatives and health care outcomes based on currently accepted clinical practice guidelines and total quality improvement initiatives.
EDUCATION AND EXPERIENCE:
Current Registered Nurse licensure from the State of Nebraska or approved compact state of residence as defined by the Nebraska Nurse Practice Act. Minimum of two (2) years recent clinical experience required. Prior care coordination and/or utilization management experience preferred. Basic Life Support (CPR) certification required.
ACUTE REHABILITATION
ADDITIONAL JOB FUNCTIONS:
In addition to the principal job functions contained on the primary job descriptions, the following duties are also required in the department noted above.
  1. Responsible for the early identification of potential patients through interdisciplinary team members and medical record review.
  2. Provides education to patients, family and support members, internal and external referral sources on Rehab program benefits and services; coordinates tours of facility when requested.
  3. Performs utilization review activities, including preadmission screening, insurance verification for benefits, medical necessity reviews, denial and appeals and coordinates admissions with admitting physicians and staff.
  4. Serves as an internal and external resource regarding Medicare/Medicaid rules, regulations and policies; 3rd party and managed care contracts, and authorization for post-acute services.

EMERGENCY DEPARTMENT
ADDITIONAL JOB FUNCTIONS:
In addition to the principal job functions contained on the primary job descriptions, the following duties are also required in the department noted above.
  1. Collaborates with the ED physicians, admitting physicians, and Bed Management to assist in determining appropriate bed status/classification for all patients.
  2. Completes medical necessity reviews utilizing approved evidence based guidelines/criteria for patients being admitted to the hospital from all portals of entry, including but not limited to: ED admissions, direct admissions, hospital to hospital transfers, post procedure admissions, and surgical admissions.
  3. Completes high risk screening for discharge planning and coordinates with social work and healthcare partners for potential post-acute needs.
  4. Serves as an internal and external resource regarding appropriate level of care; admission status/classification; Medicare/Medicaid rules, regulations, and policies; 3rd party and managed care contracts; discharge planning; and length of stay.

UTILIZATION MANAGEMENT
ADDITIONAL JOB FUNCTIONS:
In addition to the principal job functions contained on the primary job descriptions, the following duties are also required in the department noted above.
  1. Performs utilization review activities, including concurrent and retrospective reviews as required.
  2. Determines the medical necessity of request by performing first level reviews, using approved evidence based guidelines/criteria.
  3. Refers cases to reviewing physician when the treatment request does not meet criteria per appropriate algorithm.
  4. Participates in concurrent and retrospective denials and appeals process by researching issues surrounding the denial, participating in all levels of the appeal and process follow-up.
  5. Serves as an internal and external resource regarding appropriate level of care; admission status/classification; Medicare/Medicaid rules, regulations, and policies; 3rd party and managed care contracts; discharge planning; and length of stay.

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