RN Care Manager: Discharge & Transition Specialist

Care New England; Warwick (RI); On-site; USD 85,000 - 115,000; Full time

Job summary

Care New England is seeking an RN Care Manager to oversee utilization management, case management, and discharge planning for acute and extended care patients. The role focuses on assessing patient needs, preventing unnecessary readmissions, and coordinating transitions to the next level of care.

Ideal candidates hold an active Rhode Island RN license with a Bachelor’s degree in nursing; a Master’s degree is preferred.

Qualifications

• Active Rhode Island RN license required.
• Bachelor’s degree in nursing preferred.
• Masters in health-related field preferred.

Responsibilities

• Per the Utilization Management Plan, assess medical necessity to determine inpatient/observation/ambulatory status.
• Respond to insurer requests and collaborate on insurance authorization; review records for LOC and disposition.
• Communicate medical necessity, LOS goals and discharge dates to patients/families; facilitate timely transitions.
• Participate in daily rounds, coordinate care across disciplines, and ensure timely patient flow and discharge planning.
• Identify barriers to transition, engage social services, and arrange post-acute care as needed.
• Maintain confidentiality and comply with regulatory requirements; participate in performance improvement.

Skills

Case management

Utilization review

Discharge planning

Communication

Leadership

Education

RN license RI

Bachelor's degree in nursing

MS in health-related field

Job description

Care New England is seeking an RN Care Manager to oversee utilization management, case management, and discharge planning for acute and extended care patients. The role focuses on assessing patient needs, preventing unnecessary readmissions, and coordinating transitions to the next level of care.

Ideal candidates hold an active Rhode Island RN license with a Bachelor’s degree in nursing; a Master’s degree is preferred.