Provides great care for patients by working together with others to create, follow, update, and report on the case management program. Acts as a link between the patient, their family, nurses, doctors, and different team members to achieve the best results for the patient. Offers support and advice to the healthcare team about specific patient needs.

Leads the planning of patient care with other team members, making sure care is suitable and happens on time.

Checks that the care plan fits the patient’s needs, medical situation, and covered services by overseeing tests, treatments, and other care aspects that are needed for patients in a hospital.

Talks with doctors about the best use of resources, consultations, treatment plans, estimated time in the hospital, and plans for going home.

Focuses on patients with complex needs, those who often visit the emergency room, people with chronic pain and substance abuse issues, and homeless patients.

Works together with case managers in the hospital to ensure ongoing care is appropriate.

Organizes the transfer of patients to specialized medical centers, including sharing necessary information for continued treatment and services.

Ensures that all information is collected to meet required regulations and accreditations.

Handles frequent emergency room visitors by reviewing their past and current admissions.

**Requirements:**
- 2+ years of nursing experience - REQUIRED
- 6 months of home health experience - REQUIRED
- Must be able to travel - REQUIRED
- Must have a valid driver's license and car insurance - REQUIRED
- Must have a Hawaii nursing license - REQUIRED
- Experience with Homecare Home Base and OASIS - REQUIRED
- A bachelor's degree is preferred
- Case manager experience is preferred

**State License Requirements:**
- Hawaii