Utilization & Case Management RN

About This Job

You step into a vital role that transforms lives by guiding individuals through complex health and social systems. As a Case Manager, you connect vulnerable populations with the exact resources and support they need to thrive. You bridge the gap between patients, families, and healthcare providers, ensuring every person receives compassionate and effective care. This position sits at the heart of our mission, driving health equity and community wellness every single day.

Job Duties and Responsibilities

• Evaluates patient needs and creates comprehensive care plans that promote long-term stability and health.
• Delivers direct Social Services and Crisis Intervention to stabilize individuals during acute moments of distress.
• Champions patient rights through dedicated Patient Advocacy, ensuring equitable treatment across all care settings.
• Manages seamless Care Coordination and Discharge Planning to prevent hospital readmissions and support smooth transitions home.
• Conducts thorough Psychosocial Assessment to identify barriers to health and independent living.
• Performs Utilization Review to ensure appropriate resource allocation and compliance with healthcare standards.
• Facilitates Community Outreach to build strong networks and connect clients with external support systems.
• Practices expert Medical Social Work by addressing the intersection of health, mental well-being, and social factors.
• Maintains accurate, timely Documentation of all client interactions, assessments, and progress notes in alignment with organizational standards.

Required Qualifications

Education

• Bachelor Degree in Social Work, Nursing, Psychology, or a related field.
• Current license or certification in social work, nursing, or a related healthcare discipline, where applicable.

Experience

• Minimum of two years of direct experience in case management, healthcare settings, or social services.
• Demonstrated success in managing crisis situations and navigating complex community resource networks.

Knowledge/Skills

• Strong understanding of healthcare systems, social services, and discharge planning protocols.
• Excellent communication skills that foster trust with patients, families, and multidisciplinary teams.
• Proficient organizational skills to manage heavy caseloads, prioritize urgent needs, and complete accurate documentation.

Preferred Qualifications

• Master Degree in Social Work or a related human services field.
• Bilingual fluency to better serve diverse client populations.

Physical Requirements/Work Conditions

• Ability to sit and stand for extended periods during client meetings and office work.
• Frequent use of a computer for documentation and care coordination tasks.
• Occasional travel within the local community for outreach and home visits.