Case Management Registered Nurse CMRN 26-03576

Job Title: Case Management Registered Nurse
Location: Hyannis MA
Duration: 13 Weeks
Schedule: 40 hours/week (4x10)
Shift: Day Shift (7:30 AM 6:00 PM or 8:00 AM 6:30 PM)
Weekend Requirement: Every other weekend
Holiday Requirement: Every other holiday
Employment Type: Contract Onsite

Position Overview

A reputable healthcare facility is seeking an experienced Case Management RN to coordinate and facilitate patient care ensuring appropriate utilization of healthcare services and effective discharge planning. This role plays a critical part in optimizing patient outcomes while maintaining cost-effective care and regulatory compliance.

Responsibilities

• Screen new admissions daily to identify discharge planning needs
• Conduct patient assessments using InterQual or equivalent criteria
• Perform utilization review and evaluate appropriateness of level of care
• Develop and coordinate individualized care and discharge plans
• Collaborate with physicians interdisciplinary teams and third-party payers
• Facilitate patient appeals and manage HINN notices as required
• Identify high-risk patients and coordinate appropriate interventions
• Participate in interdisciplinary rounds and care conferences
• Maintain accurate and timely documentation
• Coordinate patient transfers referrals and continuity of care
• Support reimbursement processes and respond to payer inquiries
• Monitor length of stay and implement strategies to prevent denials
• Ensure compliance with regulatory standards and facility policies

Experience Requirements

• Minimum 3 years of acute care experience within the past 5 years required
• Recent experience in discharge planning and utilization review required
• Experience with InterQual or similar utilization management systems required

Education

• Bachelor of Science in Nursing (BSN) preferred

Certifications & Licensure

• Active Massachusetts RN license required
• Case Management certification (CCM CPUM or equivalent) preferred

For more details reach at or Call / Text at .

About Navitas Healthcare LLC: It is a 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.