We are seeking an experienced RN Case Manager for a 13-week assignment in an acute care hospital. The RN Case Manager performs both Care Coordination and Utilization Review, ensuring quality care, appropriate resource use, and safe discharge planning.
Responsibilities:
Perform concurrent and continued stay reviews using InterQual and Milliman criteria.
Coordinate patient discharges, arrange DME, SNF, and ambulance transport.
Manage a caseload of up to 25 patients.
Determine medical necessity based on evidence-based guidelines.
Collaborate with physicians, nurses, and social workers on care plans.
Handle prior authorizations, appeals, and denials.
Participate in family meetings and discharge planning.
Maintain documentation in Epic and ensure compliance with CMS, HIPAA, and Joint Commission standards.
Unit Details:
Setting: Acute Hospital – Case Management / Utilization Review
Shift: 5x8 Days (08:00–16:30)
Schedule: Monday–Friday, every other weekend required
Orientation: 40 hours
Caseload: Up to 25 patients
Pay quotes are an estimate of gross weekly pay, including non-taxable reimbursements, based on available information and subject to confirmation.
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