Weekend Utilization Management RN – Case Coordination

Hugh Chatham Health; Shelby (NC); On-site; USD 48,000 - 73,000; Part time

Benefits offered by this job

Health benefits

Paid Time Off

Flexible Spending Accounts

Retirement plan with employer match

Educational Assistance Program

Job summary

Advocate Health is seeking a part-time Case Manager in the Atrium Health Cleveland - Case Management department. This role coordinates with the healthcare team and payors to ensure appropriate level of care and timely authorization.

The position requires RN licensure and nursing experience; it also emphasizes documentation, regulatory compliance, and collaboration to improve throughput while supporting patient-centered care.

Qualifications

• Bachelor’s in Nursing from an accredited school of nursing, required.
• Master's degree in business or healthcare related field, preferred.
• Current RN license or temporary license as a Registered Nurse Practitioner in the state in which you work; or National License Compact state residency requirements.
• 5 years of related nursing experience preferred.
• Clinical experience within the assigned population; Case Management experience preferred.
• Strong financial and analytical skills preferred.
• Appropriate Professional certification required within 3 years of hire and per CCM Guidelines.

Responsibilities

• Coordinate with healthcare team and payors to facilitate placement of patients at appropriate level of care.
• Provide/flow clinical information to third-party payors to obtain authorization of stay.
• Perform admission and continued stay utilization reviews.
• Apply evidence-based criteria to ensure appropriate hospital level of service.
• Document utilization management activities timely and accurately.
• Identify need for clarification of physician documentation within the medical record.
• Prioritize work to ensure timely utilization management.
• Collaborate to improve throughput and reduce delays.
• Use licensed software to perform and record daily medical reviews.
• Escalate and resolve denials with payors and providers.
• Understand reimbursement criteria and regulatory requirements.
• Assist in process improvement for committees and department initiatives.
• Support Patient Centered Care Philosophy.
• Perform other duties as assigned.

Skills

Case Management

Financial Analysis

Communication Skills

Clinical Documentation

Education

Bachelor’s in Nursing

RN license

Master’s in healthcare or business (preferred)

Professional certification in Clinical Care Management (within 3 years)

Job description

Advocate Health is seeking a part-time Case Manager in the Atrium Health Cleveland - Case Management department. This role coordinates with the healthcare team and payors to ensure appropriate level of care and timely authorization.

The position requires RN licensure and nursing experience; it also emphasizes documentation, regulatory compliance, and collaboration to improve throughput while supporting patient-centered care.