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Registered Nurse (RN) Case Manager

CareTeam Solutions is looking for a PERMANENT FULL-TIME RN Registered Nurse Case Managers!!


  • Location: Attleboro, MA
  • Full Time/Perm Position(there are contract positions available as well!)
  • Great Pay and Full benefits!
  • Day Shifts/12 Hours

Position Summary: 
Supporting the Director of Case Management, the RN Case Manager Coordinator has responsibility for coordinating activities of hospital utilization management and transitions of care to promote effective utilization of hospital resources, safe and timely patient throughput and compliance with all associated state and federal regulations. Under direction of Case Management Director facilitates processes to minimize payer denials and associated revenue cycle activities. The RN Case Manager Coordinator is accountable for assessing, coordinating and facilitating patient progression through the continuum of care in an efficient, cost effective manner, providing physician education and feedback on hospital utilization.

Required Skills/Qualifications/Training/Experience:
• Minimum 3-5 years acute care case management experience, with demonstrated skills in utilization review
• Strength in data analytics to trend utilization data and report out on trends and key metrics
• Excellent computer skills: Adept at utilizing Excel and other software programs to prepare and present data and trend charts at Utilization Review Committee Meetings
• Solid knowledge of all insurance plan regulations including CMS/Medicaid to ensure compliance with all required processes and documentation, while minimizing denials.
• Strong analytical ability to interpret patient-related information, evaluate appropriateness of continued stay and/or need for ancillary services, and to reassess discharge planning needs based on daily assessment.
• Ability to successfully utilize industry accepted utilization and or medical management criteria in patient status decision making
• Self-starter able to function independently within the scope of position and licensure, as well as department policies and established goals
• Excellent computer skills to accurately document requisite information to support patient status and medical necessity

Preferred Skills/Qualifications/Training/Experience:
• Experience in Meditech and Cerner a plus
• Denials management a plus
• Strong knowledge of revenue cycle activities

Educational Requirements:
• BSN Graduate of an accredited school of nursing

• RN with current Massachusetts license required
• CCM (Certified Case Manager) and/or
• ACMA (Accredited Case Manager)

Dean M. Powers
Senior Recruitment Consultant | careteamsolutions
P: 866-708-0798 x 110
Text: 720-707-2173

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Published on 09/30/2020