RN Care Coordination & Utilization Specialist II

SUN Delaware; Georgetown (DE); On-site; USD 65,000 - 90,000; Full time

Job summary

SUN Behavioral Delaware in Georgetown, DE is seeking a Case Manager with RN licensure to coordinate patient care from admission to discharge within a hospital setting.

The role emphasizes documentation, collaboration with physicians and social workers, and ensuring appropriate services and coverage through review with insurers. A bachelor-level education background and active nursing license are required.

Qualifications

• Current RN license in the state of employment.
• Licensure or certification in applicable health-care fields.

Responsibilities

• Coordinate and implement case management plans from admission to discharge.
• Review intake assessments within 24 hours of admission.
• Coordinate care with physicians, nurses, social workers, and referrals departments.
• Communicate with third-party payers to validate need for services and coverage.
• Ensure documentation complies with HIPAA and hospital policies.
• Participate in performance improvement activities and safety programs.

Skills

Case management

Healthcare coordination

Communication

HIPAA compliance

Education

RN license in state of employment

Healthcare administration master (optional)

Job description

SUN Behavioral Delaware in Georgetown, DE is seeking a Case Manager with RN licensure to coordinate patient care from admission to discharge within a hospital setting.

The role emphasizes documentation, collaboration with physicians and social workers, and ensuring appropriate services and coverage through review with insurers. A bachelor-level education background and active nursing license are required.