RN Case Manager: Elevate Care & Optimize Resources

Care New England; Warwick (RI); On-site; USD 90,000 - 120,000; Full time

Job summary

Care New England is seeking a Registered Nurse to analyze medical records for utilization, determine the appropriate level of care, and support resource management to ensure high-quality patient care across hospital services.

The role includes chart reviews for medical necessity and quality of care, coordinating with discharge planning, communicating with patients and families about hospital stays, and collaborating with departments to ensure accurate payment and bed utilization.

Qualifications

• Bachelor’s Degree in Nursing is required.
• RN license is required.

Responsibilities

• Analyze patient’s medical record for proper utilization or resources (beds and services) and accurate payment.
• Develop the Hospital data base for case management and severity implications.
• Analyze patient’s charts for quality of services rendered and intervene to assure the delivery of quality care.
• Communicate to patient and/or patient’s family as necessary regarding the medical necessity of hospital stay.
• Communicate to appropriate departments to accurately determine level of care at discharge as well as participate in discharge planning.
• Performs all other related duties as assigned.

Education

Bachelor’s Degree in Nursing

RN license

Job description

Care New England is seeking a Registered Nurse to analyze medical records for utilization, determine the appropriate level of care, and support resource management to ensure high-quality patient care across hospital services.

The role includes chart reviews for medical necessity and quality of care, coordinating with discharge planning, communicating with patients and families about hospital stays, and collaborating with departments to ensure accurate payment and bed utilization.