About the job
This part-time Case Manager (RN) position at Luminis Health centers on coordinating patient care throughout the weekend in Annapolis, MD. The role involves close collaboration with the Clinical Director of Care Management to assess both health and social factors that influence patient outcomes. Case Managers ensure patients receive the right resources and support at the right time, using evidence-based guidelines to determine care levels and manage denial reviews for Medicare, Medicaid, and commercial payers.
Key Responsibilities
- Identify and prioritize patients who would benefit from care management, factoring in biopsychosocial, functional, cultural, spiritual, and financial considerations. Work with a multidisciplinary team to assess needs and plan care.
- Engage patients through motivational interviewing and other techniques to promote self-care, adherence to treatment, and improved health outcomes.
- Use evidence-based guidelines such as InterQual to support quality care, reduce variability, and limit unnecessary services. Confirm appropriate care levels, enter clinical reviews, and document to help prevent denied days.
- Oversee observation stay patients by ensuring timely tests and treatments, and facilitate either conversion to inpatient status or safe discharge as appropriate.
- Develop and coordinate transition plans for patients moving to home care, community care coordination, hospice, palliative care, or skilled post-acute providers. Complete all required documentation and handoffs.
- Maintain detailed and clear documentation in patient records, including information on physical and functional limitations, psychosocial factors, educational needs, and available support systems for patients and families.
Schedule and Location
This is a part-time position based in Annapolis, MD. Weekend availability is required.
