Care Management Nurse - PRN
Kristen Altland
Talent Acquisition Consultant Senior
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8:30am to 9:00pm
Shifts primarily covering the Emergency Departments but also flexing to in house units based upon department needs
Weekend and holiday rotations required
Previous experience in care management, discharge planning, previous nursing experience in ED, critical care, trauma, step down units, medical, surgical, geriatrics are all strongly preferred
General Summary
Performs a variety of duties and applies utilization and care management techniques to determine the most efficient use of resources to support the provision of appropriate, cost effective and quality health care. Works in a team type assignment or Care Coordination Team (CCT) Model (Care Manager and Social Worker teams are assigned to patients by physician practice) to address patient care transition needs. Provides leadership in the integration of utilization and care management principles throughout the hospital.
Duties and Responsibilities
- Performs initial reviews for medical necessity and appropriateness of setting for the assigned case load.
- Conducts concurrent reviews to ensure medical necessity for continued hospitalization and initiates problem-solving techniques as needed to prevent over and/or under utilization.
- Liaisons between third party payers and the treatment team regarding the identified treatment plan in accordance with contractual guidelines or System policy.
- Assists the patient care team with the identification and coordination of alternative treatment settings which will provide appropriate care, maintain quality of care and reduce cost.
- Identifies conditions which require care management across the continuum. Collaborates with the members of the patient care team to identify interdisciplinary needs.
- Makes arrangements for discharge needs (DME, Home Health, IV antibiotics, etc.) in collaboration with patients, families and care team as needed.
- Assists with the collection and analysis of utilization patterns and denied cases.
- Brings known or suspected problems of under-, over-, or inappropriate utilization of resources to the attention of the appropriate manager(s).
Common Expectations:
- Prepares and maintains appropriate documentation as required.
- Maintains established policies and procedures, objectives, quality assessment and safety standards.
- Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
Qualifications
Minimum Education:
- Associate's degree Required
Work Experience:
- 2 years Recent acute care experience. Required
- Utilization management, care management, or clinical nursing specialty. Preferred
- Previous experience in care management, discharge planning, previous nursing experience in ED, critical care, trauma, step down units, medical, surgical, geriatrics are all strongly preferred
Licenses:
- Licensed Registered Nurse Upon Hire Required or
- Registered Nurse Multi State License Upon Hire Required and
- Basic Life Support Upon Hire Required
Knowledge, Skills, and Abilities:
- Excellent interpersonal/communication skills.
You’re unique and you belong here.
At WellSpan Health, we are committed to treating all applicants fairly, regardless of their job classification. If you require assistance or accommodation due to a disability, please reach out to us via email at careers@wellspan.org. We will evaluate requests for accommodation on a case-by-case basis. Please note that we will only respond to inquiries related to reasonable accommodation from this email address. Rest assured, all requests for assistance or accommodation are handled confidentially, allowing applicants to share their needs openly and honestly with us.
Team Member Benefits
Did you know we’ve already invested to keep medical insurance premiums stable and will continue to invest to ensure they remain unchanged in 2026?
Our medical, dental and vision benefits are among the best in the country, with team members contributing only about 13% of their payroll wages—far below the national average.
In our most popular plan, WellSpan Plus, you pay 0% co-insurance after meeting your deductible. Even in our other plans, the coinsurance rate is just 5%, which is significantly lower than the typical cost for health care workers.
Ready to learn more about our comprehensive benefits? Visit WellSpan Benefits.
- Sign on incentives for new employees
- Medical, dental and vision insurance
- Life and accidental death insurance
- PTO bridging
- Short term disability
- Contact us to learn more
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Belonging at WellSpan
WellSpan Health creates an environment that fosters belonging, ensures every team member feels comfortable, connected and able to contribute and delivers personalized experiences that empower everyone to excel.
At WellSpan, people aren’t just employees. We’re individuals, and we want to be treated as unique human beings. That’s why we’re committed to creating One Size Fits One Human Experiences. After all, we are friends and neighbors, serving and working alongside our friends and neighbors.
WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability or any other legally protected characteristic. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.
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