Acute Care Nurse Navigator & Case Manager

MedCadre; Sylvania (OH); On-site; USD 55,000 - 83,000; Full time

Job summary

MedCadre is seeking a qualified healthcare professional for an acute hospital setting. The role involves day shifts (8:00–16:30) with four weekends per 13-week contract as needed. You will support MS Case Management and Utilization Review, perform care coordination, and ensure medical necessity per guidelines.

Experience in discharge planning, disease management, and order DME is essential. Proficiency in Epic and CarePort will be required, with SBAR communication and collaboration across

Qualifications

• 2 years of acute hospital experience required.
• MS Case Management/Utilization Review experience recommended.
• Familiar with medical necessity determinations and discharge planning.

Responsibilities

• Admission criteria assessment and coordination.
• Manage appeals and denials processes.
• Care coordination across disciplines.
• Determine medical necessity per evidence-based guidelines.
• Discharge planning and post-acute coordination.
• Disease management and needs assessment/Order DME.
• Develop and monitor Plan of Care.
• Complete Pre-Cert reviews and Prior Authorizations.

Skills

Care coordination

Medical necessity

Tools

Epic

CarePort

Job description

MedCadre is seeking a qualified healthcare professional for an acute hospital setting. The role involves day shifts (8:00–16:30) with four weekends per 13-week contract as needed. You will support MS Case Management and Utilization Review, perform care coordination, and ensure medical necessity per guidelines.

Experience in discharge planning, disease management, and order DME is essential. Proficiency in Epic and CarePort will be required, with SBAR communication and collaboration across