A healthcare organization in Chicago is seeking an experienced RN Case Manager to oversee inpatient utilization management, ensure effective care coordination, and support safe discharge planning. The role involves working closely with physicians and interdisciplinary teams to optimize patient outcomes and comply with regulations. Candidates should have strong communication and organizational skills, proficiency in Microsoft Word and Excel, and at least two years of relevant clinical experience. This position offers a salary range of $80,000 to $95,000 annually.
Qualifications
Graduate of an accredited nursing program.
2+ years of relevant clinical experience preferred.
Knowledge of Medicare, Medicaid, Managed Care, and Commercial insurance processes.
Responsibilities
Perform inpatient utilization management and medical necessity reviews.
Collaborate with physicians and care teams on patient management and discharge planning.
Collect and submit clinical data to support DRG accuracy and payer requirements.
Identify and resolve barriers to care progression and discharge delays.
Coordinate referrals to social services and community resources.
Communicate potential denials or level-of-care concerns to physician advisors.
Serve as a central liaison between internal teams and external stakeholders.
Promote cost-effective care without compromising quality or patient safety.
Skills
Strong communication skills
Organization skills
Customer service skills
Proficiency in Microsoft Word
Proficiency in Microsoft Excel
Education
Graduate of an accredited nursing program
Job description
A healthcare organization in Chicago is seeking an experienced RN Case Manager to oversee inpatient utilization management, ensure effective care coordination, and support safe discharge planning. The role involves working closely with physicians and interdisciplinary teams to optimize patient outcomes and comply with regulations. Candidates should have strong communication and organizational skills, proficiency in Microsoft Word and Excel, and at least two years of relevant clinical experience. This position offers a salary range of $80,000 to $95,000 annually.