Hybrid Inpatient Case Manager

Job Description

The Nurse Case Manager, RN (Inpatient) is responsible for coordinating high-quality, cost-effective, and medically appropriate care for hospitalized patients. This role focuses on concurrent review, utilization management, discharge planning, and care transitions to support safe and timely movement across levels of care.

Key Responsibilities

• Performing admission and concurrent review using MCG guidelines to assess medical necessity and level of care
• Collaborating with interdisciplinary teams to develop safe and effective care plans
• Identifying barriers to discharge and implementing care coordination strategies
• Supporting regulatory compliance, utilization management, and quality improvement initiatives
• Facilitating care conferences and interdisciplinary rounds
• Ensuring timely documentation and adherence to organizational and payer requirements

Qualifications

• Active NYS RN license required
• BSN preferred
• 3–5+ years of acute care hospital experience required
• Prior experience in inpatient case management, utilization management, or care coordination strongly preferred
• Strong knowledge of MCG guidelines, discharge planning, and transitions of care
• Excellent communication, organizational, and critical thinking skills

Compensation

$95,000 – $105,000 base salary plus bonus potential