Job Description: RN Case Manager at Riley Children's Health

Riley Children's Health, Indiana’s largest pediatric healthcare provider with over 50 locations across the state, is seeking an RN Case Manager to join our dedicated team. As one of the nation’s leading pediatric healthcare networks, we offer comprehensive care through a multidisciplinary approach that covers all aspects of pediatric health. Our reputation for excellence is affirmed by our status as Indiana's only pediatric research hospital and our ranking among the top hospitals nationally, as recognized by U.S. News & World Report.

Riley Children's Hospital in Indianapolis presents a remarkable opportunity for the right candidate. While prior pediatric experience is advantageous, it is not a strict requirement. This full-time position operates Monday through Friday during day shifts, with the potential to work remotely on Wednesdays after training. If you are ready to advance your nursing career with Indiana's premier healthcare system, we encourage you to apply today!

Benefits: As part of our renowned healthcare system, both part-time and full-time employees enjoy a diverse benefits package, which includes:

Competitive compensation Professional development opportunities Tuition reimbursement 401(k) match Paid medical leave Health, dental, and vision insurance

Key Responsibilities: The RN Case Manager plays a critical role in planning and coordinating patient care from pre-admission through post-discharge. Responsibilities include:

Collaborating with a multidisciplinary team to assign appropriate levels of care. Ensuring patients receive necessary services and are transitioned smoothly to the right post-discharge care. Conducting timely and effective discharge planning. Coordinating with third-party payers to secure coverage. Implementing educational and preventive programs for patients.

Qualifications:

Associate's Degree in Nursing required. New ASN RNs hired after January 1, 2013, will be required to complete their BSN within 5 years of hire date. Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license. Certification in Case Management preferred. Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred. Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred. Ability to comprehend third party contractual arrangements is preferred. Understanding of the third party denial and appeal process is preferred. Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS. 3-5 years of experience required. Requires strong clinical background in acute care.

Join us at Riley Children's Health, where your expertise will help shape the future of pediatric care!