Job Description:
Job Title: Nurse Case Manager
Location: Las Vegas, NV 89102
Duration: Permanent
Shift Schedule: Flexible shifts including days, evenings, nights, weekends, and holidays
Hours: Guaranteed 36 - 40 Hours/Week
Pay Range: $100-121K(Full Time)
Responsibilities:
Coordinate patient care from admission through discharge in alignment with established care plans.
Perform comprehensive assessments to evaluate discharge needs, level of care, and resource requirements.
Apply medical necessity criteria and perform utilization reviews in collaboration with physicians and insurance providers.
Support the development and implementation of individualized patient care plans.
Communicate with patients, families, and interdisciplinary teams to ensure efficient and appropriate transitions of care.
Assist in evaluating treatment effectiveness, progress toward goals, and resource utilization.
Maintain accurate and timely documentation using case management systems.
Ensure compliance with hospital policies, regulatory standards, and payer requirements.
Skills/Experience Needed:
Minimum 3 years of nursing experience in an acute care hospital setting – Required
At least 1 year of Case Management, Discharge Planning, or Utilization Review experience – Required
3+ years of Case Management experience in acute care – Preferred
Pediatric Case Management experience – Preferred
Emergency Department or Utilization Review experience – A Plus
Strong knowledge of medical necessity criteria and third-party reimbursement rules
Excellent communication and interpersonal skills under high-stress situations
Ability to work independently and collaboratively in a fast-paced hospital setting
Proficient in interpreting medical records and clinical documentation
Comfortable using EHR systems and case management software
Education:
Graduation from an accredited school of nursing – Required
Bachelor’s or Master’s Degree in Nursing – Preferred
(Master’s in Nursing with Case Management concentration may substitute for some experience)
Certifications:
Valid Nevada RN License – Required
Basic Life Support (BLS) – Required (American Heart Association accepted)
One or more of the following is a plus:
Certified Case Manager (CCM)
Accredited Case Manager (ACM)
Membership in CCMC, ACCM, or ACMA