Case Manager – Discharge Planning - Hyannis, MA - MS 26-13460

Job Title: Case Manager – Discharge Planning
Location: Hyannis, MA
Job Type: Contract
Duration: 17 weeks
Shift: Day
Schedule: 40 hours/week | Rotating days | 4x10 | Every other weekend | Rotating holidays
Local Candidates Required: No
Traveler Candidates Required: Yes

Pay Rate
Local: N/A
Traveler: $70–$76/hour

Note: This job doesn't offer any benefits.

Position Overview
We are seeking an experienced RN Case Manager to coordinate discharge planning, utilization review, care transitions, and clinical care coordination for acute-care patients.

Required Qualifications

• Current Massachusetts RN license.

• Minimum 3 years of acute-care experience within the past 5 years OR strong hospital case management experience.

• Recent Discharge Planning and Utilization Review experience within the past 4 years.

• Working knowledge of InterQual or an equivalent utilization review system.

• Strong clinical assessment and care coordination skills.

• Excellent communication, organization, negotiation, and time-management skills.

• Ability to work independently in a fast-paced and stressful environment.

• Proficient computer skills.

Preferred Qualifications

• BSN.

• Case Management/CPUM certification.

Responsibilities

• Screen new admissions and identify discharge planning needs.

• Perform Utilization Review and assess appropriate inpatient/observation level of care using InterQual.

• Develop and coordinate individualized care and discharge plans.

• Collaborate with physicians, nurses, patients, families, payers, and the interdisciplinary team.

• Coordinate safe patient transfers to post-acute facilities, agencies, or home care.

• Provide clinical information to insurance companies and third-party payers to support continued stay and reimbursement.

• Monitor length of stay and identify days at risk for denial.

• Manage patient appeals, adverse determinations, and insurance-related issues.

• Identify complex psychosocial, financial, and legal needs and make appropriate referrals.

• Participate in daily rounds and care conferences.

• Complete required discharge planning, utilization review, notices, referrals, and regulatory documentation.

• Assist medical coders with diagnostic and procedural information needed for accurate reimbursement.

• Apply approved clinical pathways, standards of care, and Care Maps.

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