Job Title: Utilization Review / Case Manager RN
Location: Honesdale, Pennsylvania 18431
Department: Case Management
Pay: $2500/weekly
Schedule:
8-hour Day Shifts
Typical Hours: 7:00 AM – 3:30 PM or 8:00 AM – 4:30 PM
Every other weekend and holiday rotation
We are seeking an experienced Registered Nurse (RN) to join our team as a Utilization Review / Case Manager The ideal candidate will have strong clinical judgment, excellent communication skills, and a thorough understanding of utilization management, discharge planning, and care coordination.
This position plays a vital role in ensuring appropriate resource utilization and promoting high-quality, cost-effective patient care in accordance with hospital and regulatory guidelines.
Conduct utilization review for patient admissions and continued stays.
Collaborate with interdisciplinary teams to develop and implement care plans.
Facilitate communication among providers, patients, and insurance companies.
Coordinate discharge planning to ensure continuity of care.
Maintain documentation in compliance with hospital and payer standards.
Participate in performance improvement initiatives related to case management.
Current, active Registered Nurse (RN) license in the state of Pennsylvania.
Minimum of 2 years of clinical experience (acute care or case management preferred).
Strong knowledge of utilization management processes and discharge planning.
Excellent communication, critical thinking, and organizational skills.
Ability to work independently and collaboratively in a fast-paced environment.
Collaborative, team-oriented environment.
Consistent daytime schedule.
Opportunity to make a direct impact on patient outcomes and care efficiency.
