Hospital Case Manager: Care Continuity & Discharge

Aiken Regional Medical Centers; Aiken (SC); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Sign On Bonuses for select positions

Unlimited Employee Referral Bonus

Competitive Compensation & Generous PT

Excellent Medical, Dental, Vision & Rx

401(K) with company match

Job summary

Aiken Regional Medical Centers in Aiken, SC, is seeking a Case Manager to oversee admission review and discharge planning to ensure appropriate care and efficient LOS. The role requires close collaboration with payers and the interdisciplinary team to reduce denials and delays while maintaining high-quality patient care.

The position emphasizes utilization review, ongoing chart reviews, and coordination with Social Work to facilitate timely transitions from admission to discharge; BSN preferred

Qualifications

• Valid SC RN license (or compact state license).
• Minimum 3 years in acute-care hospital or related setting.
• Diploma or associate degree from an accredited RN program; BSN preferred.
• Experience with utilization review or case management preferred.

Responsibilities

• Perform chart reviews for admission, concurrent and retrospective review to certify appropriateness and reduce denial risks.
• Collaborate with payers for authorization and manage transitions from admission to discharge.
• Coordinate with SW/DCP and interdisciplinary team to plan timely discharges and manage LOS.
• Identify and manage avoidable hospital days and participate in process improvement.
• Educate staff on utilization of hospital days and resources and refer to infection control, wound care, nutrition, and peer review as needed.

Skills

Case management

Interdisciplinary collaboration

Healthcare finance systems

Knowledge of private insurance

Utilization review

Computer skills

Education

Diploma or associate degree in RN program

BSN preferred

Job description

Aiken Regional Medical Centers in Aiken, SC, is seeking a Case Manager to oversee admission review and discharge planning to ensure appropriate care and efficient LOS. The role requires close collaboration with payers and the interdisciplinary team to reduce denials and delays while maintaining high-quality patient care.

The position emphasizes utilization review, ongoing chart reviews, and coordination with Social Work to facilitate timely transitions from admission to discharge; BSN preferred