Case Manager RN - Full-Time Days

About the role

Seeking a dedicated Case Manager to serve as a care coordinator for patients, families, and caregivers. Responsibilities include conducting concurrent and retrospective reviews to ensure appropriate utilization, assess patient needs, prevent denials, and coordinate discharge plans. They facilitate safe and effective transitions by collaborating with healthcare teams, insurers, and continuing care agencies, while adhering to regulatory compliance and specific criteria.

Responsibilities

• Conduct concurrent and retrospective reviews to ensure appropriate utilization, assess patient needs, prevent denials, and coordinate discharge plans.
• Facilitate safe and effective transitions by collaborating with healthcare teams, insurers, and continuing care agencies, while adhering to regulatory compliance and specific criteria.
• Coordinate patient care and discharge planning.
• Ensure regulatory compliance through review processes.
• Collaborate with healthcare providers, patients, families, and insurers.
• Assess patient needs and optimize care utilization.

Qualifications & Skills

• Graduate of an accredited nursing program.
• BSN preferred.
• 2-3 years of Case Management experience preferred.
• Current Massachusetts RN licensure.
• Case Management certification preferred.