RN – Case Management - Hyannis, MA

NavitasPartners•Barnstable, MA

2d•$65 - $70

About The Position

"Navitas Healthcare, LLC" is seeking an experienced Registered Nurse – Case Manager to coordinate and facilitate patient care across the continuum. This role focuses on discharge planning, utilization review, and collaboration with interdisciplinary teams to ensure high-quality, cost-effective patient outcomes.

Requirements

Minimum 3 years of acute care experience within the past 5 years
Recent experience in discharge planning and utilization review
Working knowledge of InterQual® or equivalent system
Active Registered Nurse (RN) license – Massachusetts
Strong communication, organizational, and problem-solving skills
Ability to work independently in a fast-paced environment
Proficient with computer systems and healthcare software
Acute Care Experience
InterQual®

Nice To Haves

Bachelor of Science in Nursing (BSN)
Certification in Case Management (CCM), CPUM, or related specialty

Responsibilities

Perform daily screening of new admissions for discharge planning needs
Conduct initial assessments and reassessments using InterQual® criteria
Coordinate individualized care plans with physicians and interdisciplinary teams
Facilitate timely discharge planning and ensure continuity of care
Perform utilization review and evaluate appropriateness of admissions and level of care
Communicate with third-party payers to support reimbursement and ongoing services
Initiate HINN notices, discharge appeals, and reinstatement processes as needed
Identify high-risk patients and connect them with appropriate resources
Participate in daily rounds and care conferences
Advocate for patients and families regarding care plans and insurance coverage
Coordinate referrals and ensure safe patient transitions to other facilities or services
Maintain compliance with regulatory, quality, and documentation standards