RN Case Manager - Hospital Utilization & Discharge

Universal Health Services, Inc.; Aiken (SC); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Sign On Bonuses for select positions

Unlimited Employee Referral Bonus

Competitive Compensation & Generous PT

Excellent Medical, Dental, Vision and

Job summary

Aiken Regional Medical Centers, part of Universal Health Services, seeks a Case Manager (RN) for full-time assignment in Aiken, SC. The role covers admission, concurrent and retrospective reviews to ensure appropriate care and discharge planning.

The Case Manager will collaborate with payers and the interdisciplinary team to minimize denials and optimize patient flow from admission to discharge.

Qualifications

• Diploma or associate degree from an accredited RN program; BSN preferred.
• Minimum 3 years of experience in acute-care hospital or related setting.
• SC RN license or compact state license required.
• Knowledge of private insurance and Medicare criteria for hospitalization.
• Understanding of healthcare financial systems and benchmarking practices.
• Ability to facilitate change through interdisciplinary collaboration; computer skills.

Responsibilities

• Admit, review and manage patient cases to support appropriate admission and discharge.
• Collaborate with payers to reduce denials and manage cases from admission to discharge.
• Coordinate with SW/DCP to ensure safe and timely transitions of care.
• Plan discharge to minimize delays and LOS; communicate daily with staff.
• Educate staff on utilization of hospital days and resources.
• Identify and refer to Infection Control, Wound Care, Nutrition, and Peer Review as needed.

Skills

Private insurance knowledge

Medicare criteria knowledge

Healthcare finance understanding

Interdisciplinary collaboration

Computer skills

Education

RN Diploma or Associate degree

BSN preferred

Job description

Aiken Regional Medical Centers, part of Universal Health Services, seeks a Case Manager (RN) for full-time assignment in Aiken, SC. The role covers admission, concurrent and retrospective reviews to ensure appropriate care and discharge planning.

The Case Manager will collaborate with payers and the interdisciplinary team to minimize denials and optimize patient flow from admission to discharge.