RN Case Manager: Discharge Planning & Care Coordination

Hudson Regional Health; Secaucus (NJ); On-site; USD 65,000 - 85,000; Full time

Job summary

Hudson Regional Health is seeking an experienced Registered Nurse for a Case Management role in an acute care setting in New Jersey. The position focuses on case management and routine discharge planning to facilitate safe, timely discharges and optimize hospital reimbursement.

Responsibilities include chart reviews, interdisciplinary rounds, insurer communications, and coordination with care teams to streamline patient flow and length of stay.

Qualifications

• Knowledge of utilization review criteria (InterQual / Milliman preferred).
• Experience with Medicaid, Medicare, Managed Care review and documentation.
• Excellent written and verbal communication skills.
• Knowledge of discharge planning and length of stay initiatives.
• Knowledge of home care and referral processes.
• Strong problem-solving and critical-thinking abilities.

Responsibilities

• Review patient charts within 24 to 48 hours of admission to assess appropriateness and discharge needs.
• Communicate with Attending Physician and Physician Advisor on questionable cases.
• Coordinate with insurance providers for admission and stay reviews to optimize reimbursement.
• Refer denied day cases to Physician Advisor.
• Participate in Interdisciplinary D/C rounds to review and facilitate plan of care.
• Update Director of Case Management on problem areas and escalation when needed.
• Coordinate with ancillary departments to ensure timely care and discharge.
• Perform other duties as assigned.

Skills

Utilization Review

Discharge planning

Communication skills

Regulatory knowledge

Education

Registered Nurse (RN) license NJ

Acute care experience

Job description

Hudson Regional Health is seeking an experienced Registered Nurse for a Case Management role in an acute care setting in New Jersey. The position focuses on case management and routine discharge planning to facilitate safe, timely discharges and optimize hospital reimbursement.

Responsibilities include chart reviews, interdisciplinary rounds, insurer communications, and coordination with care teams to streamline patient flow and length of stay.