Case Manager I, RN - Behavioral Health Services at WakeMed Health & Hospitals

Raleigh, North Carolina, United States -

Full Time

Start Date

Immediate

Expiry Date

31 Mar, 26

Salary

0.0

Posted On

31 Dec, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Patient Support, Resource Navigation, Community Engagement, Education, Advocacy, Self-Management, Recovery, Safety Assessments, Transportation Arrangements, Social Determinants of Health, Insurance Monitoring, Utilization Reviews, Medical Record Reviews, Conflict Resolution, Time Management, Task Prioritization

Industry

Hospitals and Health Care

Description

Overview Supports patients and families in managing mental health and substance use concerns, assisting with discharge planning, resource navigation, and community engagement. Serves as a resource and placement specialist, ensuring timely referrals, warm handoffs, and effective communication. Provide education, advocacy, and support to enhance patient self-management and recovery. Facilitates inpatient and outpatient connections, monitors placements, conducts safety assessments, arranges transportation, and addresses social determinants of health. Acting as a liaison between patients, families, providers, and community resources. Proactively works to prevent delays in care and disposition. Reviews patient admissions and continued stays for appropriateness, monitors insurance benefits, and ensures care aligns with coverage to optimize payment. Assists with insurance appeals and utilization reviews. Supports clinical staff with coverage guidance and medical record reviews. Participates in the involuntary commitment process, including case tracking and representing the hospital in hearings. Must be able to work independently, prioritize tasks, and manage time efficiently. Demonstrates a flexibility in accepting diverse work assignments, managing stress related to change, and resolving conflicts effectively. Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org. EOE Licensure Registered Nurse Required Education Bachelor's Degree Nursing Required Experience No Experience Required

Responsibilities

Supports patients and families in managing mental health and substance use concerns while facilitating connections to inpatient and outpatient services. Acts as a liaison between patients, families, providers, and community resources to ensure effective communication and timely referrals.