Care Manager ER Registered Nurse

Job Summary

The Care Manager – ER collaborates with the emergency department team to assess potential admissions and determine appropriate status placement using evidence-based criteria such as MCG or third-party review tools. This role supports efficient patient flow by avoiding unnecessary admissions and guiding at-risk patients and families to appropriate community-based resources. The Care Manager – ED facilitates transitions of care, supports discharge planning, and ensures regulatory and documentation requirements are met for patients entering hospice or post-acute services.

Essential Functions

• Assesses patients in the emergency department for medical necessity of admission and ensures correct placement into inpatient, observation, or outpatient status using MCG or approved criteria.
• Identifies patients who may be appropriate for alternative care settings and works to avoid unnecessary admissions by coordinating with community resources.
• Provides timely guidance and education to patients and families regarding care transitions, including hospice services or post-acute facility placement, and secures patient choice documentation as required.
• Verifies next of kin contact information and emergency contact, and ensures accurate documentation on patient records.
• Collaborates with ED clinicians, hospitalists, care managers, and social services to support seamless transitions of care.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• Bachelor's Degree in Nursing (BSN) preferred
• 1-3 years of experience in an acute care or hospital setting required
• 1-2 years of experience in care management or utilization review preferred

Knowledge, Skills and Abilities

• Knowledge of admission criteria and care level determination tools such as MCG or InterQual.
• Strong clinical assessment and decision-making skills.
• Ability to effectively coordinate community-based services and discharge planning.
• Excellent communication and interpersonal skills for patient and interdisciplinary team interactions.
• Strong organizational skills with attention to detail and compliance documentation.

Licenses and Certifications

• RN - Registered Nurse - State Licensure and/or Compact State Licensure licensed in state of employment or compact state licensure required
• BLS - Basic Life Support preferred