What are the responsibilities and job description for the Case Management Registered Nurse - CMRN 26-03576 position at NavitasPartners?
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 jknox@navitashealth.com or Call / Text at 732-791-4827.
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.