Registered Nurse – Case Management RNVP
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Job Location:
Barnstable, MA - USA
Hourly Salary:
$ 62 - 72
Posted on:
2 days ago
Vacancies:
1 Vacancy
Job Summary
Job Title: Registered Nurse (RN) Case Management
Location: Hyannis MA
Contract Duration: 13 Weeks
Shift: Day Shift 8:00 AM 4:30 PM
Pay Rate: $62$72 per hour
Position Summary
Navitas Healthcare LLC is seeking Registered Nurse (RN) Case Managementfor an exciting job in Hyannis MA.
Key Responsibilities
Screen new admissions daily to identify discharge planning and care coordination needs
Conduct patient assessments using InterQual and approved clinical guidelines
Complete initial assessments within one business day and reassess every three days or as patient conditions change
Review and validate patient demographics and insurance information
Evaluate appropriateness of admission status and level of care (Inpatient vs. Observation)
Perform utilization review for assigned units
Initiate required notices letters and coordinate discharge appeals as needed
Collaborate with physicians and interdisciplinary teams during daily rounds
Communicate with third-party payers to support authorization and reimbursement
Identify high-risk psychosocial financial or legal needs and coordinate appropriate referrals
Advocate for patients and families regarding coverage determinations and care decisions
Coordinate safe and effective transitions of care including post-acute services
Monitor length of stay and identify days at risk for denial
Refer cases to the Physician Advisor when medical necessity criteria are not met
Support accurate coding and reimbursement in collaboration with medical coding teams
Participate in care conferences pathway development and quality initiatives
Maintain compliance with departmental policies regulatory requirements and infection control standards
Demonstrate commitment to organizational CARES values: Compassion Accountability Respect Excellence and Service
Required Qualifications
Active Registered Nurse (RN) license in the state of Massachusetts
Minimum 3 years of recent acute care experience (within the past 5 years)
Recent experience (within the last 4 years) in Discharge Planning and Utilization Review
Working knowledge of InterQual or equivalent medical necessity criteria
For more details contact at or Call / Text at .
About Navitas Healthcare LLC certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.
Required Experience:
IC
Key Skills
- EMR Systems
- Hospital Experience
- Acute Care
- ICU Experience
- Hospice Care
- Workers' Compensation Law
- Home Care
- Nursing
- Catheterization
- Critical Care Experience
- Medication Administration
- Tube Feeding
