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
Caseload: Up to 25 patients
Experience: Minimum 2 years of acute care case management experience performing Care Coordination and Utilization Review.
Hard Stops: Must have Acute Hospital Case Manager and InterQual experience.
Travel Experience: Required (first-time travelers may be considered).
Charting System: Epic (required).
Education:
ADN or BSN from an accredited nursing program (BSN preferred).
License:
Active, unrestricted Registered Nurse (RN) license in the state of assignment or Compact License.
Certifications:
BLS – Required
CCM or ACM – Preferred
At 22nd Century Healthcare, we understand the challenges faced by job seekers and recruiters in the healthcare industry. That's why we take a personalized approach to every staffing solution we offer. Our ISO-certified staffing practices and pre-vetted database of healthcare professionals can serve your immediate staffing needs. We've provided staffing services to various facilities, healthcare organizations, and government agencies, making us a trusted partner in the industry.
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