RN Case Manager Team Lead 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 to join our innovative leadership team in Case Management. This full-time position operates Monday through Friday. 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 compensationProfessional development opportunitiesTuition reimbursement401(k) matchPaid medical leaveHealth, dental, and vision insurance

Key Responsibilities: 

As a RN Case Manager Team Lead, you will play a crucial role in guiding other Case Managers in planning and coordinating patient care from pre-admission through post-discharge. You will leverage your professional nursing skills to help staff identify patterns and trends, highlighting opportunities to enhance quality, continuity of care, utilization, reimbursement, and patient satisfaction. Your responsibilities will include ensuring patients are assigned the appropriate level of care, receiving the necessary services, and being smoothly transitioned to the appropriate level of post-discharge care. Additionally, you will develop and implement education and prevention programs. 

Qualifications:

Associate's Degree in Nursing required. Must obtain Bachelor's Degree in Nursing within 5 years of hire date.Bachelor's Degree in Nursing is preferred.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.5-7 years of experience required. Experience in pediatric case management is strongly preferredRequires strong clinical background in acute care.

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