Lead RN Case Manager

About the role

The Lead RN Case Manager serves as the primary information and education resource for the interdisciplinary team, developing organization‑wide problem‑solving approaches. You will create patient‑specific care plans and coordinate with post‑acute providers to ensure seamless continuity after discharge.

Key responsibilities

• Promote optimal clinical and resource outcomes.
• Facilitate pre‑certification and payer authorization processes.
• Manage collaborative patient care across the continuum and address barriers.
• Identify and apply process‑improvement methodologies to enhance care outcomes.
• Provide expert clinical documentation support for coders and staff.
• Serve as a liaison with physicians and communications teams.
• Support team compliance with regulatory requirements.
• Partner with leadership to align goals and vision.

Required profile

• Registered Nurse with a BSN or Bachelor’s in a healthcare field.
• Current, valid RN license in Florida.
• Case Manager Certification (CCM) required within one year of hire.
• Minimum six years of experience in care management, utilization review, or discharge planning.
• Demonstrated leadership, strong analytical and data‑management abilities.
• Excellent interpersonal communication and negotiation skills.
• Knowledge of discharge planning, utilization management, performance improvement, and managed‑care reimbursement.
• Understanding of pre‑acute and post‑acute care venues and community resources.

Required skills

• Data management
• PC skills
• Analytical skills
• Discharge planning
• Utilization management
• Performance improvement
• Managed‑care reimbursement