RN Case Manager: Hospital Utilization & Discharge

Universal Health Services; Aiken (SC); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Sign-on bonuses for select positions

Tuition reimbursement after 6 months

Generous paid time off

Job summary

Universal Health Services is seeking a Case Management (RN) professional for a full-time position at Aiken Regional Medical Centers in Aiken, South Carolina. The role focuses on admission, concurrent and retrospective chart reviews, and close collaboration with payers to reduce denials and ensure safe discharge planning.

The ideal candidate has an SC RN license, 3 years of acute-care experience, and knowledge of private insurance, Medicare criteria, and health care financial systems.

Qualifications

• Active SC RN license or compact state license.
• Minimum 3 years experience in acute-care hospital or related setting; utilization review/case management experience.
• Knowledge of private insurance, Medicare criteria, and healthcare financial systems.
• Strong computer skills and ability to document accurately.

Responsibilities

• Perform admission, concurrent, and retrospective chart reviews to certify appropriateness of admission and avoid denials.
• Collaborate with payers to manage transitions and discharge planning.
• Coordinate with SW/DCP and interdisciplinary teams to optimize LOS and resource use.
• Educate staff on utilization of hospital days and resource management.
• Facilitate transitions of care to ensure timely discharge.

Skills

RN license

Case management

Payer communications

Computer literacy

Education

Diploma or Associate Degree in Nursing

BSN preferred

Job description

Universal Health Services is seeking a Case Management (RN) professional for a full-time position at Aiken Regional Medical Centers in Aiken, South Carolina. The role focuses on admission, concurrent and retrospective chart reviews, and close collaboration with payers to reduce denials and ensure safe discharge planning.

The ideal candidate has an SC RN license, 3 years of acute-care experience, and knowledge of private insurance, Medicare criteria, and health care financial systems.