RN Case Manager

Assess patients, coordinate care, support discharge and transition planning, and manage ongoing outpatient care. Develop care plans, educate patients and families, promote self-care, supervise LPNs and home health aides, document progress, and collaborate with the care team in a home and community-based setting. Assess patients and work with the care team to develop and implement plans of care. Refer patients to other disciplines based on identified needs and document referral decisions. Educat…