RN - Case Manager - Hyannis, MA - MS 26-11262
$70 - $76 per hourCompu-Vision - Northeast
Job Description
Job Description
Job Title: Registered Nurse - Case Manager
Location: Hyannis, MA
Job Type: Contract
Duration: 13 Weeks
Shift & Schedule: Day Shift | 8:00 AM – 4:30 PM | Monday – Friday | 40 Hours/Week | Rotating Days, Every Other Weekend & Rotating Holidays
Local Candidates Required: No
Traveler Candidates Required: Yes
Pay Rate: $70 – $76/hr
Position Overview
We are seeking an experienced RN Case Manager to coordinate discharge planning, utilization review, and patient care across an acute care hospital setting.
Required Qualifications
Current Massachusetts Registered Nurse (RN) license.
Minimum 3 years of acute care experience within the past 5 years in a hospital or case management setting.
Recent discharge planning and utilization review experience within the past 4 years.
Working knowledge of InterQual® or an equivalent utilization review system.
Strong clinical assessment, communication, organization, negotiation, and time-management skills.
Proficient computer skills and ability to adapt to updated software systems.
Ability to work independently in a fast-paced environment.
BSN preferred.
Case Management, CPUM, or specialty certification preferred.
Responsibilities
Screen admissions for discharge planning and care coordination needs.
Assess patient needs using InterQual®, Care Maps, clinical pathways, and established standards.
Perform utilization review and evaluate admission and continued length-of-stay appropriateness.
Develop and coordinate individualized discharge and care plans with the interdisciplinary team.
Coordinate with physicians, patients, families, insurance companies, and third-party payers.
Provide clinical information to payers and identify patients at risk for denials.
Coordinate appeals, discharge appeal rights, HINN notices, and related documentation.
Identify complex psychosocial, financial, and legal needs and connect patients with appropriate resources.
Participate in daily unit rounds and care conferences.
Coordinate patient referrals and transfers to other facilities or agencies.
Maintain accurate documentation and required paperwork while supporting compliance with hospital policies and regulatory standards.
$80 - $85 per hour
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