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Registered Nurse-Transitional Case Management

Indiana University Health · Lafayette, Indiana, United States

Job Title: Registered Nurse - Transitional Case Management

Location: IU Health Arnett

Schedule: Monday – Friday, Day Shift, Hybrid Remote (25-50% in office requirement)

Position Summary:

IU Arnett Hospital is seeking a dedicated and experienced Registered Nurse - Transitional Case Management to join our team. In this pivotal role, you will coordinate care for high-risk patients post-discharge, with a focus on reducing readmissions and ensuring seamless transitions across care settings. This position offers an excellent opportunity to make a meaningful impact on patient outcomes through comprehensive discharge planning, patient education, and collaborative care management.

Key Responsibilities:

- Collaborate with multidisciplinary teams to develop and implement individualized care plans for patients from pre-admission through post-discharge.

- Identify high-risk patients and implement targeted interventions to prevent readmission, ensuring smooth transitions of care.

- Conduct thorough phone triage to assess patient needs, provide education, and coordinate necessary services.

- Demonstrate strong problem-solving skills by identifying barriers, collaborating on solutions, offering alternatives, and following up to ensure resolution.

- Utilize positive reinforcement techniques by recognizing patient achievements, encouraging progress, and providing specific praise to foster engagement.

- Ensure patients are appropriately assigned to the correct level of care and receive necessary services, including post-discharge support and follow-up.

- Perform accurate, timely discharge planning and documentation, facilitating effective communication with patients, families, and healthcare team members.

- Demonstrate accountability and follow-through by providing timely reminders, ensuring the delivery of necessary materials, and maintaining ongoing patient engagement.

- Work with third-party payers to secure coverage and approvals, ensuring financial clearance for services.

- Administer patient education and prevention programs to promote health and wellness.

- Monitor, evaluate, and modify care plans as necessary to optimize patient outcomes.

- Maintain compliance with medical record documentation, healthcare regulations, and organizational policies.

Qualifications:

- Requires an Associates of Nursing (ASN).

- Bachelors of Nursing (BSN) preferred.

- Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.

- Requires that the RN has graduated from a nationally accredited nursing program.

- Minimum of 3-5 years of relevant experience, preferably in ambulatory care, home health, or care management.

- Phone triage experience is preferred.

- Requires Basic Life Support certification through the AHA.

- Other advanced life support certifications may be required per unit/department specialty according to patient care policies.

- Requires proficiency in Microsoft Office and applications.

- Requires understanding of medical record requirements, regulations and policies.

Skills and Competencies:

- Excellent communication, organizational, and critical-thinking skills.

- Proven problem-solving skills, including the ability to: - Identify barriers

- Collaborate on solutions

- Offer alternatives

- Follow up effectively

- Ability to utilize positive reinforcement strategies: - Recognize achievements

- Encourage progress

- Provide specific praise

- Demonstrated accountability and follow-through: - Provide reminders

- Ensure materials are delivered

- Maintain ongoing engagement with patients

Why Join IU Arnett Hospital?

At IU Health, we are dedicated to providing outstanding patient care and fostering a collaborative, supportive work environment. This role offers a rewarding opportunity to make a meaningful difference in patients’ lives while advancing your nursing career. Join our team and be part of a community committed to excellence, innovation, and compassionate care. Apply today, we would love to hear from you!

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