Registered Nurse (RN) – Case Manager - RNCM#002

NavitasPartners • Barnstable, MA

22h

About The Position

The RN Case Manager is responsible for coordinating and facilitating patient care throughout the hospital stay, ensuring quality and cost-effective outcomes. This role includes discharge planning, utilization review, and collaboration with interdisciplinary teams to optimize patient care and resource utilization.

Requirements

• Bachelor of Science in Nursing (BSN) preferred
• Active Massachusetts RN License (required)
• Minimum 3 years of acute care experience within the last 5 years
• Experience in discharge planning and utilization review
• Working knowledge of InterQual or equivalent system (required)
• Strong understanding of healthcare regulations and payer requirements
• Ability to work independently in a fast-paced environment

Nice To Haves

• Case Management Certification (preferred)

Responsibilities

• Assess patient needs and develop individualized care and discharge plans
• Perform daily admission reviews and identify discharge planning requirements
• Conduct utilization reviews using InterQual or equivalent criteria
• Collaborate with physicians, nurses, and interdisciplinary teams
• Coordinate with insurance providers for authorization and reimbursement
• Monitor patient progress and update care plans as needed
• Educate patients and families on care plans and discharge processes
• Identify high-risk patients and coordinate appropriate support services
• Participate in care rounds and case conferences
• Maintain accurate documentation and ensure compliance with policies

What This Job Offers

• Career Level: Mid Level
• Number of Employees: 1-10 employees