RN Case Manager – Day Shift (Travel Contract) - RNKP#01

NavitsPartners • Boston, MA

15h • Onsite

About The Position

"Navitas Partners, LLC" is seeking an experienced RN Case Manager to support care coordination and utilization management within an acute care setting. This role focuses on facilitating timely, high-quality, and cost-effective patient care by collaborating with interdisciplinary teams, payers, patients, and families. The RN Case Manager plays a critical role in discharge planning, utilization review, and ensuring safe transitions of care while advocating for optimal patient outcomes.

Requirements

• Active Massachusetts RN license required
• Minimum 3 years of recent acute care experience (within the past 5 years)
• Demonstrated experience in discharge planning and utilization review
• Working knowledge of InterQual® or equivalent utilization criteria
• Strong communication, organizational, and computer skills
• Ability to work independently in a fast-paced, high-pressure environment

Nice To Haves

• BSN preferred
• Case Management certification (e.g., CCM, CPUM ) or specialty certification preferred

Responsibilities

• Screen admissions for discharge planning needs and complete initial InterQual® assessments within one business day; reassess every three days or as clinically indicated
• Review admission status and level-of-care appropriateness (Inpatient vs. Observation) and issue required notices (e.g., HINN) in a timely manner
• Coordinate payer communications, reimbursement processes, and appeal activities as needed
• Participate in daily interdisciplinary rounds and collaborate with Physician Advisors on high-risk or complex cases
• Develop individualized discharge plans aligned with covered services and patient needs
• Educate patients and families on community resources and post-acute care options
• Ensure safe, compliant, and timely transitions to post-acute settings

What This Job Offers

• Career Level: Mid Level
• Education Level: No Education Listed