RN Case Manager – Hospital Discharge & Utilization

Universal Health Services, Inc.; Aiken (SC); On-site; USD 65,000 - 90,000; Full time

Job summary

Aiken Regional Medical Centers, part of Universal Health Services, Inc., seeks a full-time Case Manager (RN) to oversee admission, concurrent and retrospective reviews for multiple patient populations. The role requires close payer collaboration to reduce denials and ensure timely discharge planning in a high-quality acute care setting.

Responsibilities include chart reviews, denial management, discharge planning, and interdisciplinary collaboration to optimize patient flow and resource use.

Qualifications

• Diploma or associate degree from an accredited RN program; BSN preferred.
• SC RN license (or compact state license).
• Minimum of 3 years acute-care hospital experience.
• Experience with utilization review or case management.
• Knowledge of private insurance and Medicare criteria.
• Computer skills and ability to facilitate interdisciplinary collaboration.

Responsibilities

• Performs chart reviews (admission, concurrent and retrospective) to certify appropriateness of admission, accurate status, continued stay and reduce denial risks.
• Follows processes for denial management and referrals as appropriate.
• Interfaces with payers for authorization and case review (VERSALUS HEALTH where applicable).
• Monitors patients on the floor for progression of care and discharge readiness; conducts discharge planning to minimize delays.
• Collaborates with nursing, social work and other Interdisciplinary team to anticipate discharges and manage LOS.
• Maintains documentation quality to support admission/continuation of acute hospital stay.

Skills

RN

Case management

Interdisciplinary collaboration

Discharge planning

Documentation

Insurance processes

Education

Diploma or Associates in Nursing

BSN preferred

Job description

Aiken Regional Medical Centers, part of Universal Health Services, Inc., seeks a full-time Case Manager (RN) to oversee admission, concurrent and retrospective reviews for multiple patient populations. The role requires close payer collaboration to reduce denials and ensure timely discharge planning in a high-quality acute care setting.

Responsibilities include chart reviews, denial management, discharge planning, and interdisciplinary collaboration to optimize patient flow and resource use.