Job Description

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 – ER 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 or social 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 ensures accurate documentation on patient records. Collaborates with ED clinicians, hospitalists, case managers, and social services to support seamless transitions of care. Performs other duties as assigned. 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 required