Utilization Review Case Manager - Home Care

Visiting Nurse and Hospice for VT and NH; White River Junction (VT); Remote; USD 60,000 - 80,000; Full time

Job summary

Visiting Nurse and Hospice for Vermont and New Hampshire seeks a Utilization Review Case Manager to enhance patient care through coordination, management, and support. This role offers flexibility with shifts and a chance to provide impactful care. Ideal candidates will possess an RN license and experience in home health.

Benefits

Clinical CEUs

Qualifications

• Registered Nurse with experience in Home Health.
• Knowledge of Medicare regulations is essential.
• Experience in managing care plans and patient coordination.

Responsibilities

• Collaborates with primary clinician to create a patient care plan.
• Continuously reviews and manages the patient's plan of care.
• Coordinates and communicates with patients and caregivers.

Skills

Knowledge of Medicare regulations

Experience with Electronic Medical Records

Proficient in Excel

Proficient in Word systems

Education

Graduate of an accredited school of nursing

Unencumbered RN License in both VT and NH or active compact license

Job description

Visiting Nurse and Hospice · Home Health

White River Junction , VT

Nursing (Other)

Per Diem , Days , Monday, Friday and one Flex Day

Posted 06/05/2025

Why work as a Utilization Review Case Manager at Visiting Nurse and Hospice for Vermont and New Hampshire?

• You experience satisfying and challenging work that makes a difference, every day.
• You really get to know your patients and become an integral part of their care team.
• You are provided broad independence but are also part of a cohesive interdisciplinary team.
• You get to be an important part of the community where you live.
• You have a work/life balance that can match the flexibility you need.

Benefits include:

• Clinical CEUs

Schedule:

• Mondayand Fridayare eight-hourshiftswith one 4-hour flex shift to be discussed with hiring manager.

Locations:

• Fully remote work in all states except: CA, CT, MA, MD, NJ, NY, OH, RI, WY.

Visiting Nurse and Hospice for VT & NH covers more than 70 towns, delivering superior nursing, rehabilitation, hospice, and personal care services with proven effectiveness, integrity, and compassion. Our only goal is to help the people in our communities. When you join Visiting Nurse and Hospice for VT & NH, you’ll become part of a dedicated team delivering outstanding home health and hospice services that enrich the lives of the people we serve.

Utilization Review Case Managers at VNH focus on providing pain management and comfort for patients with terminal or chronic illnesses, as well as communicating and coordinating care needs with the interdisciplinary team, the patient and their families/caregivers.

The URCM:

• Collaborates with primary clinician, provider, patient, their family and/or the primary care givers upon admission to create a plan for patient’s care.
• Continuously reviews the patient’s plan of care and collaborates with primary clinician throughout patient’s episode to ensure the patient’s plan of care aligns with care being provided.
• Coordinates and manages the patient’s plan of care, including but not limited to: order review, resource management, measuring outcomes, and communication and collaboration with patient, caregiver and attending provider.
• Collaborates with primary clinician in identifying need for referral for interdisciplinary services.
• Utilizes key performance indicators associated with value-based purchasing, patient driven grouping models, and patient satisfaction to guide patient care and utilization.
• Completes clinical review of referrals and collaborates with the intake and referral teams.

Minimum Qualifications:

• Graduate of an accredited school of nursing.
• Unencumbered RN License in both VT and NH or active compact license.
• Demonstrated knowledge of Medicare regulations and Medicare Conditions of Participation (CoP).
• Minimum of 2 years’ experience in Home Health
• Experience with Electronic Medical Records
• Proficient in Excel and Word systems

We would love to meet you and tell you more about this engaging and fulfilling part of our healthcare delivery system. Our recruiters can explain the different roles, our service area, the unique aspects of home and hospice care, and the many benefits we can offer your career and personal life.

Visiting Nurse and Hospice for Vermont and New Hampshire (VNH) will never require candidates to provide personally identifying information such as social security number, date of birth, street address, or banking information in order to submit an application for employment. Identifying information will only be requested after an offer of employment has been extended and accepted, for the purposes of security screening and onboarding. If you experience a request for your personal information prior to acceptance of an offer of employment, please contact VNH’s Human Resources Department immediately at 888.300.8853 or [e-mail].

As part of Dartmouth Health, Visiting Nurse and Hospice for VT & NH is an equal-opportunity employer.