RN Case Manager - Discharge & Utilization Lead

The Health Care Authority for Baptist Health, An Affiliate of UAB Health System; United States; On-site; USD 75,000 - 95,000; Full time

Job summary

Baptist Health in Alabama is seeking an RN Case Manager to coordinate discharge planning and utilization management. You will work with physicians, nursing staff and other health professionals to optimize resource use, ensure high-quality patient care, and support accurate documentation.

Responsibilities include admission, continued stay and discharge reviews, collaboration with payers to ensure appropriate reimbursement, and compliance with regulatory guidelines.

Qualifications

• Nursing degree with active RN license.
• 2+ years hospital case management experience.
• Knowledge of utilization management and discharge planning.
• Case Manager certification preferred.

Responsibilities

• Coordinate discharge planning and care coordination for assigned caseload.
• Perform utilization management reviews from admission to post-discharge.
• Collaborate with interdisciplinary team and payers to optimize resources.
• Reconcile orders and ensure compliance with regulations and guidelines.

Skills

Communication skills

Independence

Interpersonal skills

Computer skills

Attention to detail

Education

Bachelor's degree in Nursing

Active RN license

Case Manager certification (preferred)

Job description

Baptist Health in Alabama is seeking an RN Case Manager to coordinate discharge planning and utilization management. You will work with physicians, nursing staff and other health professionals to optimize resource use, ensure high-quality patient care, and support accurate documentation.

Responsibilities include admission, continued stay and discharge reviews, collaboration with payers to ensure appropriate reimbursement, and compliance with regulatory guidelines.