RN Clinical Coordinator/Case Manager (50/50 Role)

RN Case Manager

Position Summary

The Clinical Coordinator/Case Manager serves in a dual-capacity role, dedicating approximately 50% of time to clinical coordination and department operations and 50% of time to direct patient case management activities. This position supports the coordination and oversight of care management processes while maintaining an active caseload to ensure high-quality, patient-centered care across the continuum.

Responsibilities 

• Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as:




• MCG- Milliman Care Guidelines


• R1- Physician Advisor


• Payer Portal Administrator




• Coordinate all aspects of new hire orientation including (not all inclusive):




• Development of Orientation Calendar


• Assignment of Preceptors


• Hardware/ Software Needs and Accesses


• Preceptor/ Preceptee Documentation-Support


• Develop/ Maintain New Hire Orientation Manuals




• Develop/ Ensure Annual Case Management Competencies




• MCG: Interrater Reliability


• MCG LMS Coursework


• DNV/JC Case Management Competencies




• Collaborate with Health System Clinical Coordinators




• Preceptor Training




• Develop and Maintain Case Management Education Calendar




• Design and Facilitate Education surrounding EPIC upgrades/ changes.


• Facilitate clinical education on current best practices




• Develop/ Maintain CM Database with all CM related education/ resources


• Serve as Expert/ Maintain knowledge of all CM related functions and workflows including:




• Utilization Review


• Denials/ Appeals Management


• Discharge Planning


• Medicare Compliance


• Mental Health/ Substance Use


• Readmission Reduction




• Perform all duties as assigned in Case Management Role

Requirements

• Current R.N. licensure in Ohio (must be maintained)


• 2 years active Acute Case Management Experience


• Obtain Case Management Certification within one year of employment in role


• Current CPR card and maintain.


• Maintain knowledge of new technology and equipment


• Ability to work independently.


• Successful candidate must have excellent critical thinking skills.


• LMH is accredited by DNV and TJC, and as such, may require specific annual education related to specialty certifications and standards.

Licking Memorial Health Systems is an equal opportunity employer and maintains compliance with all state, federal, and local regulations. Licking Memorial Health Systems does not discriminate against applicants because of race, color, religion, sex, sexual orientation, age, ancestry, national origin, veteran status, pregnancy, disability, marital status, or other characteristics protected by law.