Nursing Jobs in Beltsville, MD
$75,545.60 - $125,923.20 / year
The Case Manager Hybrid I/II will provide case management services to patients and their families or caregivers. This role involves both discharge planning and utilization review components. The Case Manager Hybrid I/II as an onsite role act as the central hub of patient care, ensuring continuity, efficiency, and quality outcomes for complex, chronic, or high-risk cases. They bridge the gap between providers, patients, and external resources to manage health outcomes proactively. Assist with direct patient assessment, participate in planning and implementation of intervention and ensure follow-up and coordination of services. Leads or participates in in-person or virtual care team planning meetings, acting as the primary point of contact for the team. Advocates for patient needs, addresses barriers to care (such as social determinants), and ensures alignment across the interdisciplinary team. Manages a panel of complex patients, focusing on reducing avoidable admissions and optimizing resource utilization. Engage in outreach activities in the community to effectively case manage to discharge. Assist with administrative tasks, as needed for all patients and families. Review and authorize hospital days by ensuring the care provided aligns with insurance company guidelines, reducing the risk of denied claims. Part of the role includes Identifying and securing community resources, including Medicaid, Medicare, or other funding programs through high-risk process for patients, helping to manage the financial aspects of complex cases. Use analytic tools to predict and prevent unnecessary readmissions, reducing costs for both the patient and the organization. All nursing practice is based on the legal scope of practice, national and specialty nursing standards, Children's National Policies and Procedures, and in accordance with all applicable laws and regulations. The Professional Model of Care requires registered professional nurses to be responsible and accountable for their own practice and assigned/covering patients. Children's National supports the development of RN relationships within the community; specifically, those relationships associated with the health and well-being of the community at large. Minimum Education Bachelor's Degree (Required) Master's Degree (Preferred) Minimum Work Experience 5 years' experience with at least three (3) in an acute inpatient setting (Required) Experience in one or more of the following areas: designated/pediatric specialty, program/project development, clinical pathways or leadership (Required) Required Licenses And Certifications Registered Nurse (Required) Functional Accountabilities Current certification in Case Management or Utilization Management (Preferred) Professional Practice/Research Participate in Shared Leadership. Contribute to the MAGNET Journey of Children’s National. Ensure nursing practice is based on evidence of best practice. Accountable to participate in the Nursing Division’s Performance Improvement process (division or unit level). Participate in community activities. Patient Resource Services Communicate denials, high risk, or changes in level of care using accepted processes to limit financial risk to CNMC and patients’ families. Navigate internal and external systems to accurately identify or secure payers and link patients to needed services. Discharge Transitional Plan of Care Lead and proactively define discharge and transitional care criteria daily with the healthcare team to facilitate efficient care transitions. Conduct an initial assessment within 1 day of patient and family to identify potential discharge barriers and needs in accordance with departmental and regulatory requirements. Document in EHR and escalate timely to leadership any barriers Develop and implement a plan of care and make referrals based on a needs assessment and available resources in conjunction with care team members. Transition care to external providers and services to achieve quality outcomes for patient and family . Provide clinical reviews/referrals to third party payers using nationally recognized medical necessity criteria and validate authorization or denial of services and document appropriately in EHR (Initial Assessment & ongoing assessment) Case Management Nursing focused Follow High Risk Process (Uninsured/Social/Financial Risk) Monitor Length of Stay (LOS) and Document Avoidable Days/Delays for all patients assigned Timely handoff to teams (nursing/CM/Provider) to ensure continuity of care for all patients Documentation Document according to departmental policy. Abide by nursing practice guidelines Initial Assessment 1-2 days of admission and Ongoing assessment weekly. Document daily if needed as ongoing patient care management occurs Document parent guardian choice for each patient with a case management need (ex: DME/PDN/Placement etc) Performance Improvement Identify, implement, and evaluate processes to improve customer service, reimbursement and/or hospital performance. Participate in the identification of Process Improvement issues and take steps to improve unit or CRM processes. Promote the development of CRM department and other members of the healthcare team. Identify gaps in care coordination, discharge planning, and resource utilization Ensure adherence to regulatory and accreditation standards (e.g., CMS, Joint Commission, DOH) Work closely with other case managers, social workers, physicians, payors and nursing staff Utilize department tools to track key performance indicators (KPIs) such as length of stay (LOS), Avoidable days, readmission rates, and care transitions Effectively manage patent ratio of 1:30 for safe discharge Primary Location District of Columbia-Washington Work Locations Rehab and Specialized Care Organization Finance Position Status R (Regular) Work Schedule M-F 0830-5pm Rotating Weekend on call Job Posting May 27, 2026, 11:17:31 PM Full-Time Salary Range 75545.6 
$82,347.20 - $137,238.40 / year
Children's National Hospital is growing! This permanent Charge Nurse role is perfect for the experienced PICU nurse seeking advancement into leadership! Full-Time | Rotating Shifts The American Association of Critical-Care Nurses (AACN) previously awarded the Children's National Pediatric Intensive Care Unit with a silver-level Beacon Award for Excellence. The three-year award marked an important milestone on the path to exceptional patient care and achieving a healthy work environment. The silver-level designation signifies continuous learning and effective systems to achieve optimal patient care and shows alignment practices with AACN's six Healthy Work Environment Standards. The Pediatric Intensive Care Unit (PICU) is a 46-bed unit. We will be expanding to 60 beds in 2027! This unit serves as a regional referral center and is a designated Level I Trauma Center for comprehensive care to pediatric patients and their families. The PICU Patient Care Management Team coordinates interdisciplinary patient assessment and patient care and provided by pediatric intensivists and specialty nurses in conjunction with multiple specialty services within the Medical Center. Patients are admitted to the PICU from the ED, Trauma Services, the Operating Room, and transfers from in-house units as well as transports from other institutions via the Pediatric Transport team. Trauma patients comprise about 10%-15% of patients in the PICU. These patients often have multiple injuries or severe head trauma. The PICU is also a Pediatric Burn Center and receives referrals from the region. Other complex patients requiring general surgery, ENT, craniofacial, neurosurgical and other surgical subspecialties are also cared for in the PICU. Medical patients comprise 50%-60% of patients and include children with respiratory failure, meningitis or seizures, sepsis, multi-system organ failure and chronically ill children. Children with cancer also require PICU care for complications that develop as part of the underlying disease, chemotherapy or following bone marrow transplantation. Services are provided daily, 24 hours per day. The Division of Critical Care Medicine (CCM) provides services and care to all patients admitted to the Pediatric Intensive Care Unit (PICU). Specifically, care is provided for all patients in the PICU, patients within the hospital by request, patients within the hospital as part of all emergencies and resuscitations, and patients in the ED for “medical alerts” and “trauma stats”. The scope of services includes resuscitation, life support, monitoring and treatment for life threatening events and diagnostic issues related to these items. Patients may be admitted to and discharged from the PICU based on pre-established guidelines. See section on critical care units. The department utilizes a multi-disciplinary approach to care, utilizing the services of physicians, nurse practitioners, nurses, respiratory therapists, social services and other support services necessary to provide quality care. Attending physicians providing care are board eligible or certified in Pediatric Critical Care. The PICU provides CAT (Rapid Response Services) and Code Blue team leadership to support in house clinical emergencies. An attending or fellow along with an ICU nurse and Respiratory Therapist respond to assist in clinical rescues of in-house patients. This service can also be activated by a concerned parent. All nursing practice is based on the legal scope of practice, national and specialty nursing standards, CNMC Policies and Procedures, and in accordance with all applicable laws and regulations. The Professional Model of Care requires registered professional nurses to be responsible and accountable for their own practice. CNMC supports the development of RN relationships within the community; specifically those relationships associated with the health and well being of the community at large. The Shift Coordinator, on a shift to shift basis, directs the activities of and/or participates as a member of the patient care delivery team. In collaboration with unit leadership, participates in planning, managing and evaluating unit based clinical care and ensuring that continuity of care is maintained. Minimum Education Bachelor's Degree (Required) Minimum Work Experience 2 years Nursing experience. (Required) 1 year Recent pediatric experience in a comparable setting. (Required) Required Skills/Knowledge The Shift Coordinator, will successfully complete the hospital and nursing orientation at CNMC. Required Licenses And Certifications Registered Nurse in District of Columbia . Functional Accountabilities Professional Practice/Research Participate/support Shared Leadership. Contribute to CNMC’s Magnet Journey. Ensure that nursing is based on evidence of best practice. Accountable for supporting/participating in the Division of Nursing’s Performance Improvement process. Participate in community activities. Participates in Assessment, Planning, and Implementation of Nursing Process Continuously perform patient/family assessments as necessary to ensure needs are met. Assess and modify skill mix and staffing levels using manager or clinical coordinator for complex issues. Function as a resource in planning patient discharge and all clinical issues. Utilize multidisciplinary approach to meeting patient care needs. Demonstrates Ability to Communicate Effectively Demonstrate therapeutic communication skills by adopting techniques for specific situations. Provide performance feedback to all staff in a constructive, timely manner. Effectively manage conflict resolution. Serve as consumer advocate for patient/family concerns. Educates Patient/Family Facilitate learning opportunities for all staff. Ensure that patient/family educational needs are met. Safety Speak up when team members appear to exhibit unsafe behavior or performance Continuously validate and verify information needed for decision making or documentation Stop in the face of uncertainty and takes time to resolve the situation Demonstrate accurate, clear and timely verbal and written communication Actively promote safety for patients, families, visitors and co-workers Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance Organizational Accountabilities Demonstrates Demonstrate awareness of cost containment strategies by efficiently planning staffing patterns, level and mix to meet patient care needs. Ensure staff adherence to unit/hospital policies. Participate in the performance appraisal process for all staff. Implement change with a positive impact. Display strong leadership in a team environment through example. Demonstrate initiatives and leadership through involvement in projects and committee work. Organizational Commitment/Identification Partner in the mission and upholds the core principles of the organization Committed to diversity and recognizes value of cultural ethnic differences Demonstrate personal and professional integrity Maintain confidentiality at all times Customer Service Anticipate and responds to customer needs; follows up until needs are met Teamwork/Collaboration Demonstrate collaborative and respectful behavior Partner with all team members to achieve goals Receptive to others’ ideas and opinions Performance Improvement/Problem-solving Contribute to a positive work environment Demonstrate flexibility and willingness to change Identify opportunities to improve clinical and administrative processes Make appropriate decisions, using sound judgment Cost Management/Financial Responsibility Use resources efficiently Search for less costly ways of doing things Primary Location District of Columbia-Washington Work Locations CN Hospital (Main Campus) Job Nursing Organization Patient Services Position Status R (Regular) Shift Rotating Work Schedule FT, DNR, EOW, 12hr/ shifts Job Posting Apr 15, 2026, 9:01:34 PM Full-Time Salary Range 82347.2 
