ED Case Manager (RN) – Onsite, Sign-On Bonus

College of Pastoral Supervision and Psychotherapy; Pinehurst (NC); On-site; USD 72,000 - 95,000; Full time

Benefits offered by this job

Sign-on Bonus Eligible

Relocation assistance

Great benefits package

Fitness membership

Career Development

PSLF Qualifying Employer

Job summary

FirstHealth of the Carolinas in Pinehurst, NC, seeks an experienced RN for an ED Case Manager role in a non-remote, hospital-based setting. The position emphasizes determining medical necessity, managing level of care, and coordinating with physicians and payers.

Responsibilities include discharge planning support, denials review, and interdepartmental communication to ensure efficient patient flow and appropriate utilization of resources.

Qualifications

• Bachelor’s Degree in Nursing required or Associate Degree with additional years of experience.
• Master Degree in Nursing or related field preferred.
• ACM or CCM Case Management certification preferred.

Responsibilities

• Review new patient records for medical necessity and level of care.
• Refer Medicare/Medicaid recipients not meeting criteria to Physician Advisor.
• Follow through with recommendations for Level of Care with orders and notices.
• Provide hospital-issued letters of non-coverage per CMS regulations.
• Submit clinical information to payers and respond to requests within same business day.

Education

Bachelor’s Degree in Nursing

Associate Degree in Nursing

Master Degree in Nursing or related field

Job description

FirstHealth of the Carolinas in Pinehurst, NC, seeks an experienced RN for an ED Case Manager role in a non-remote, hospital-based setting. The position emphasizes determining medical necessity, managing level of care, and coordinating with physicians and payers.

Responsibilities include discharge planning support, denials review, and interdepartmental communication to ensure efficient patient flow and appropriate utilization of resources.