Registered Nurse - Case Management - RN25-32779

Job Title: Registered Nurse – Case Management

Location: Hyannis, MA 02601

Contract Duration: 13 Weeks

Schedule: Rotating Days, 8:00 AM – 4:30 PM | Every Other Weekend | Rotating Holidays

Pay Rate: $55 – $60 per hour

Position Summary

"Navitas Healthcare, LLC" is seeking Registered Nurse – Case Management for an exciting job in Hyannis, MA.

Responsibilities

• Conduct daily screenings for discharge planning needs and establish visit priorities.

• Review new admissions for level of care appropriateness using InterQual® or equivalent criteria.

• Complete initial and reassessments for patients with discharge planning needs.

• Collaborate with physicians, interdisciplinary teams, and payers to coordinate care and services.

• Facilitate communication with third-party payers, providing concurrent clinical updates to support ongoing care and reimbursement.

• Identify and address high-risk psychosocial, financial, or legal issues through appropriate referrals.

• Participate in daily rounds and ensure discharge plans align with patient needs and coverage.

• Advocate for patients regarding care decisions, insurance determinations, and appeal processes.

• Coordinate safe transitions of care by ensuring complete and accurate referral information.

• Maintain compliance with hospital policies, safety, infection control, and quality standards.

• Participate in pathway development, utilization reviews, and case management improvement initiatives.

• Support accurate documentation to ensure appropriate reimbursement and coding.

Qualifications

• Active RN License in the state of Massachusetts (required)

• Minimum 3 years of acute care experience within the past 5 years

• Experience in Case Management and Utilization Review (within the last 4 years)

• Working knowledge of InterQual® or equivalent criteria-based review systems

• Bachelor of Science in Nursing (BSN) preferred

• Certification in Case Management (CCM or equivalent) preferred

• Strong interpersonal, negotiation, and communication skills

• Excellent organizational and time management abilities

• Proficient with electronic health records and clinical software systems

For more details contact at [email protected]

About Navitas Healthcare, LLC certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.