Case Management Nurse

Infojini Healthcare; Chicago (IL); On-site; USD 80,000 - 95,000; Full time

Job summary

A healthcare organization in Chicago is seeking an experienced RN Case Manager to oversee inpatient utilization management, ensure effective care coordination, and support safe discharge planning. The role involves working closely with physicians and interdisciplinary teams to optimize patient outcomes and comply with regulations. Candidates should have strong communication and organizational skills, proficiency in Microsoft Word and Excel, and at least two years of relevant clinical experience. This position offers a salary range of $80,000 to $95,000 annually.

Qualifications

• Graduate of an accredited nursing program.
• 2+ years of relevant clinical experience preferred.
• Utilization management experience strongly preferred.
• Knowledge of Medicare, Medicaid, Managed Care, and Commercial insurance processes.

Responsibilities

• Perform inpatient utilization management and medical necessity reviews.
• Collaborate with physicians and care teams on patient management and discharge planning.
• Collect and submit clinical data to support DRG accuracy and payer requirements.
• Identify and resolve barriers to care progression and discharge delays.
• Coordinate referrals to social services and community resources.
• Communicate potential denials or level-of-care concerns to physician advisors.
• Serve as a central liaison between internal teams and external stakeholders.
• Promote cost-effective care without compromising quality or patient safety.

Skills

Strong communication skills

Organization skills

Customer service skills

Proficiency in Microsoft Word

Proficiency in Microsoft Excel

Education

Graduate of an accredited nursing program

Job description

💰 Salary: $80,000 – $95,000 annually

About the Role

We are seeking an experienced RN Case Manager to support inpatient utilization management, care coordination, and safe discharge planning. This role works closely with physicians, interdisciplinary teams, and payers to ensure appropriate level of care, regulatory compliance, and optimal patient outcomes.

Key Responsibilities

• Perform inpatient utilization management and medical necessity reviews
• Collaborate with physicians and care teams on patient management and discharge planning
• Collect and submit clinical data to support DRG accuracy and payer requirements
• Identify and resolve barriers to care progression and discharge delays
• Coordinate referrals to social services and community resources
• Communicate potential denials or level-of-care concerns to physician advisors
• Serve as a central liaison between internal teams and external stakeholders
• Promote cost-effective care without compromising quality or patient safety

Qualifications

• Graduate of an accredited nursing program
• 2+ years of relevant clinical experience preferred
• Utilization management experience strongly preferred
• Knowledge of Medicare, Medicaid, Managed Care, and Commercial insurance processes
• Strong communication, organization, and customer service skills
• Proficiency in Microsoft Word and Excel