New PDN Company Looking for an RN Case Manager. This is a Huge Opportunity for Growth!
Sunshine Pediatric Day Center is a Prescribed Pediatric Extended Care (PPEC) facility delivering an innovative model of medical day care to medically complex and technology-dependent children. Our team of nurses, therapists, and child-care professionals provides skilled nursing care in a warm, engaging, family-centered
environment — giving kids a place to thrive during the day and giving caregivers the support they deserve.
The Opportunity
We are seeking a Registered Nurse Case Manager with PDN experience to serve as the clinical quarterback for each child enrolled
in our PDN program. This role owns the full lifecycle of patient care coordination — from referral and intake
through ongoing plan-of-care management, family education, physician communication, payer authorization,
and continuity across home, school, and outside providers.
If you love the relationship-building side of pediatric nursing, are highly organized, and want a role where you
advocate for kids and families while keeping clinical operations running smoothly — this is it.
Qualifications
Required:
Active, unrestricted Registered Nurse (RN) license in the state of practice
Current BLS/CPR certification (AHA preferred); PALS preferred
Minimum 2–3 years of pediatric nursing experience (PPEC, pediatric home health, pediatric skilled nursing, PICU, NICU, or pediatric long-term care)
Working knowledge of medically complex, technology-dependent pediatric care (trach, vent, G-tube, centrallines, seizure precautions, oxygen therapy)
Strong understanding of pediatric plans of care, physician orders, and care coordination
Excellent written and verbal communication skills
Proficiency with EHR systems and Microsoft Office / Google Workspace
Preferred:
BSN
Prior case management, care coordination, or utilization review experience
Experience working with Medicaid, Medicaid MCOs (STAR Kids, STAR), and private insurance for pediatric authorizations
Familiarity with PPEC, pediatric medical day care, or pediatric skilled nursing regulations
Bilingual (English/Spanish) a plus
Case Management Certification (CCM, ACM, or RN-BC) a plus
Core Responsibilities
Intake, Referrals & Admissions
Serve as the primary clinical point of contact for incoming referrals from hospitals, physicians, discharge planners, MCOs, and community partners
Review referrals for clinical appropriateness and PPEC admission criteria
Conduct or coordinate initial nursing assessments, gather medical records, and verify physician orders
Partner with the Administrator and Director of Nursing on admission decisions and onboarding logistics
Plan of Care Management
Develop, implement, and continuously update individualized plans of care for each enrolled child
Ensure plans of care reflect current physician orders, diagnoses, equipment needs, medication regimens, therapy goals, and family preferences
Conduct regular case reviews and reassessments at required intervals
Coordinate with the medical director, PCPs, specialists, and therapists to keep care plans aligned and current
Care Coordination & Continuity
Act as the clinical liaison between families, physicians, therapists, home health agencies, schools, programs, hospitals, and equipment vendors
Coordinate transitions of care (hospital admissions/discharges, ER visits, specialist appointments, new diagnoses)
Track upcoming appointments, immunizations, screenings, and follow-up needs
Support families with navigating the healthcare system, accessing community resources, and understanding their child's care
Authorizations, Documentation & Compliance
Obtain and maintain insurance authorizations and reauthorizations (Medicaid, MCOs, private payers);submit clinical documentation to support medical necessity
Maintain accurate, timely, and HIPAA-compliant documentation in the EHR
Ensure case files meet state, federal, and payer regulatory requirements
Participate in chart audits, survey readiness, and quality improvement initiatives
Family Engagement & Education
Build trusting, long-term relationships with families as their consistent point of clinical contact
Educate caregivers on diagnoses, equipment, medications, and care plan goals
Resolve concerns and escalations with empathy and professionalism
Advocate for the child and family across the care continuum
Team Collaboration
Partner with bedside RNs, LPNs, therapists, and clinical leadership to ensure consistent execution of each child's plan of care
Communicate plan-of-care changes promptly to the clinical team
Contribute to interdisciplinary care conferences and team huddles
Support clinical leadership with census growth, retention, and program development
What We Offer
Competitive pay commensurate with experience
Medical, dental, and vision insurance
401(k) participation
Paid time off and paid holidays
Predictable Monday–Friday daytime schedule
Paid CEUs and professional development
Low patient ratios, relationship-based care, and a mission-driven culture
Schedule & Setting
Employment Type: Full-Time, Exempt
Schedule: Monday–Friday, daytime hours; occasional flexibility for family or provider communication
Setting: Pediatric Prescribed Extended Care (PPEC) / Pediatric Medical Day Care / Skilled Nursing
Specialty Areas: Pediatric case management, pediatric skilled nursing, pediatric home health, pediatric long-term care