Case Management Nurse

IntePros; Philadelphia (Philadelphia County); Remote; USD 10,000 - 60,000; Full time

Job summary

An innovative staffing firm is seeking a Senior Healthcare Recruiter to join their dynamic team. This role focuses on enhancing patient outcomes through effective care management and utilization reviews. You'll be responsible for coordinating care transitions, collaborating with healthcare professionals, and ensuring compliance with standards. The position offers an opportunity to make a significant impact in the healthcare industry while working remotely. If you have a passion for quality care and possess strong clinical judgment, this is the perfect opportunity for you.

Qualifications

• Must have an active RN license in PA, NJ, or DE.
• 3+ years of acute care clinical experience required.

Responsibilities

• Conduct utilization management reviews for inpatient admissions.
• Collaborate with physicians to review treatment plans.
• Facilitate early discharge planning for patients.

Skills

Clinical Judgment

Problem-Solving

Verbal Communication

Written Communication

Organizational Skills

Collaboration

Customer Service

Education

Registered Nurse (RN) License

Bachelor of Science in Nursing (BSN)

Job description

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This range is provided by IntePros. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$40.00/hr - $45.00/hr

Direct message the job poster from IntePros

Senior Healthcare Recruiter @ IntePros | Technology Staffing

MUST reside in PA,NJ, or DE and have an active PA,NJ, or DE RN license

RN Care Management Coordinator – Infusion Therapy Team (Remote)

About the Role:

Under the guidance of the Care Management and Coordination Supervisor, the RN Care Management Coordinator performs telephonic or onsite reviews of hospital admissions, ensures appropriate utilization of healthcare resources, and facilitates early and effective discharge planning. This role is key to driving quality care, promoting efficient use of services, and enhancing patient outcomes.

Key Responsibilities:

• Conduct utilization management reviews for inpatient admissions (onsite or remote).
• Assess the need for inpatient care, continued stay, and appropriate length of stay using medical criteria software.
• Coordinate care transitions to the most appropriate, cost-effective settings without compromising quality.
• Collaborate with attending physicians to review treatment plans and clarify medical necessity.
• Identify hospital admissions that no longer meet inpatient criteria and present cases to Medical Directors as needed.
• Evaluate members for discharge planning needs early in their hospital stay.
• Work with hospital staff, physicians, and families to facilitate smooth, timely discharges.
• Identify cases for case management or disease management referrals.
• Flag quality-of-care concerns and report them to the appropriate departments.
• Maintain accurate and timely documentation in internal systems.
• Comply with state, federal, and accreditation standards in all utilization decisions.
• Support provider education and build positive relationships across the healthcare network.
• Report trends, utilization issues, and improvement opportunities to leadership.

Required Qualifications:

• Registered Nurse (RN) license in good standing (BSN preferred).
• Minimum 3 years of acute care clinical experience (hospital or similar setting).
• Experience in discharge planning and/or utilization management strongly preferred.
• Valid driver’s license and reliable transportation (for occasional onsite needs).

Key Skills:

• Strong clinical judgment and problem-solving skills.
• Excellent verbal and written communication across all levels.
• Highly organized with strong documentation and follow-through abilities.
• Proven ability to collaborate effectively with cross-functional teams.
• Customer-focused and committed to delivering exceptional service.

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Contract

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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