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Nexus Health Systems

Lead RN Case Manager

northern, KY

Check who can apply and the requirements below before continuing.

About this opportunity

Nexus Health Systems lists this Lead RN Case Manager opportunity in northern, Kentucky. Review the employer’s description below for duties, qualifications and application requirements.

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Lead RN Case Manager

Full Time Shenandoah, TX, US

30+ days ago Requisition ID: 2136

About Nexus Children’s Hospital – Shenandoah

Nexus Children’s Hospital – Shenandoah specializes in providing comprehensive, pediatric-focused care for children and adolescents with complex medical, neurological, and rehabilitative needs. Our interdisciplinary approach supports recovery, independence, and long-term quality of life through coordinated medical care, therapy services, and family engagement. We are committed to empowering patients and families throughout their healthcare journey with compassion, expertise, and a collaborative spirit.

Position Summary

The RN Case Manager is responsible for assessing patient and family psychosocial needs, planning and coordinating care, and evaluating clinical progress across the healthcare episode. This role ensures cost-effective care delivery within appropriate length of stay while preventing fragmentation of services. Working collaboratively with physicians, payors, and an interdisciplinary healthcare team, the RN Case Manager supports age-specific and patient-focused outcomes, linking resource management with quality care.

Job Responsibilities

General Responsibilities

Maintains PHI and HIPAA compliance according to hospital policy and federal regulations.

Promotes a safe working environment and safe patient care at all times.

Practices "minimum information necessary" when performing utilization review, case management, and discharge functions.

Acts as a patient advocate for all patients within the facility.

Adheres to all regulatory, company, and ethical standards of practice.

Demonstrates respect, professionalism, and confidentiality at all times.

Supports and models the organization’s mission, vision, and values.

Case Management & Coordination

Conducts initial and ongoing patient assessments, focusing on clinical needs, discharge criteria, and family support.

Plans, coordinates, and facilitates interdisciplinary care conferences.

Evaluates ongoing treatment plans and collaborates with providers for necessary adjustments.

Prevents service duplication and ensures appropriate use of resources.

Collaborates with third-party payors to provide medical information and support authorization processes.

Coordinates discharge planning, ensuring safe and effective transition to the next level of care.

Patient & Family Engagement

Serves as a primary communication point for patient families and outside agencies.

Provides education regarding treatment goals, discharge needs, and community resources.

Facilitates problem-solving and addresses barriers to discharge or care progression.

Qualifications

Current RN license in the State of Texas (required)

Bachelor of Science in Nursing preferred

Case Management certification (ACM or CCM) preferred

Prior experience in pediatrics, rehabilitation, acute care, behavioral health, or complex medical case management strongly preferred

Strong communication skills and ability to work effectively with families under stress

Experience with utilization review or managed care interaction is a plus

Why Join Nexus?

Mission-driven pediatric and neuro-rehabilitation environment

Collaborative and supportive interdisciplinary culture

Opportunity to impact children and families facing complex healthcare challenges

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