RN CLINICAL CARE NAVIGATOR/ CASE MANAGER

RN Clinical Care Navigator – Short-Term Skilled Care

Location: Mt Laurel Healthcare & Rehab Center

Schedule: Monday–Friday (9:00 AM – 5:00 PM or 10:00 AM – 6:00 PM)

On-Call Rotation: One week every 10 weeks (Monday 7:00 AM – Monday 7:00 AM)

Salary: $80,000 – $95,000 (based on experience)

Position Summary

The RN Clinical Care Navigator plays a key leadership role in coordinating and managing the care of short-term skilled nursing residents. This position oversees case management, insurance review coordination, and interdisciplinary collaboration to ensure residents receive the appropriate level of care while progressing toward a safe and successful discharge.

This role serves as the central point of coordination between nursing, therapy, social services, admissions, and families to ensure seamless transitions from hospital to skilled nursing and ultimately back to the community.

The RN Clinical Care Navigator also supports quality outcomes by proactively identifying clinical risks, coordinating timely interventions, and helping reduce avoidable emergency room visits and hospital readmissions.

Key Responsibilities

Skilled Case Management & Insurance Coordination

• Manage continued stay reviews and payer communications for skilled residents.
• Coordinate insurance authorizations and concurrent reviews with Medicare Advantage and commercial payers.
• Monitor resident progress and collaborate with therapy and nursing to support continued skilled coverage when appropriate.
• Ensure clinical documentation supports medical necessity and skilled services.

Admission Coordination & Transition Support

• Coordinate the clinical preparation for new short-term admissions.
• Assign resident rooms and ensure rooms are prepared prior to arrival.
• Communicate key resident information to nursing staff to support a smooth and welcoming transition.
• Identify and communicate any social, behavioral, or clinical needs prior to admission.
• Partner with admissions, nursing, and social services to ensure a positive and organized admission experience for residents and families.

Interdisciplinary Care Coordination

• Participate in Interdisciplinary Team (IDT) meetings to review skilled residents and progress toward goals.
• Collaborate with therapy, nursing, and social services to ensure care plans support optimal recovery and discharge planning.
• Assist the team in identifying and resolving barriers that may delay recovery or discharge.

Quality Outcomes & Risk Identification

• Monitor short-term skilled residents for early signs of clinical decline or complications.
• Identify potential risks and collaborate with nursing and providers to implement early interventions.
• Support initiatives that reduce avoidable emergency room visits and hospital readmissions.
• Assist in tracking and improving outcomes related to short-term rehabilitation success, safe discharges, and quality measures.
• Promote proactive communication among team members to ensure timely responses to changes in resident condition.

Care Planning & Clinical Support

• Assist with development of the baseline care plan for new admissions.
• Ensure care plans reflect resident goals, clinical needs, and discharge objectives.
• Support accurate clinical documentation related to skilled services and resident progress.
• Assist with ICD-10 coding review for new admissions to support proper documentation and reimbursement.

Discharge Planning Support

• Work closely with Social Services to ensure safe, timely, and successful discharges.
• Identify potential discharge barriers early and assist the team in addressing them.
• Promote patient choice and provide education to residents and families regarding post-discharge services and supports.

Nursing Support

• Participate in the nursing on-call rotation approximately every 8–10 weeks.
• Provide clinical guidance and support as needed during assigned rotation.

Qualifications

• Active Registered Nurse (RN) license in the state of Pennsylvania.
• Minimum 2 years of clinical nursing experience (skilled nursing, case management, or rehabilitation preferred).
• Experience with Medicare, Medicare Advantage, and insurance authorization processes preferred.
• Knowledge of post-acute care coordination, discharge planning, and interdisciplinary care planning.
• Strong organizational, communication, and problem-solving skills.

Why Join Our Team

• Be part of a growing skilled nursing organization focused on quality, outcomes, and patient-centered care.
• Play an important role in improving short-term rehabilitation success and reducing hospital readmissions.
• Work alongside a collaborative team dedicated to helping residents recover, regain independence, and return home safely.

Pay: $80,000.00 - $95,000.00 per year

Benefits:

• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off

Work Location: In person

Salary : $80,000 - $95,000