Travel - Registered Nurse (RN) – Case Management - CCMA

Job Title: Travel - Registered Nurse (RN) – Case Management
Location: Hyannis, MA
Assignment Type: Travel Contract
Duration: 13 Weeks
Shift: Monday to Friday | 8:00 AM – 4:30 PM
Total Weekly Compensation: $2,762 – $2,890

Position Overview:

We are seeking an experienced Registered Nurse (RN) specializing in Case Management for a 13-week travel assignment in Hyannis, MA. The Case Manager will coordinate and facilitate patient care across the continuum to ensure high-quality, cost-effective outcomes. This role requires strong clinical judgment, the ability to collaborate effectively with interdisciplinary teams, and a commitment to delivering compassionate care.

Key Responsibilities:

• Conduct daily admission screenings and prioritize patients requiring discharge planning
• Complete initial assessments and reassessments using InterQual® within specified timelines
• Review appropriateness of admissions and levels of care; follow established escalation protocols when criteria are not met
• Facilitate appeals and initiate required notices (e.g., HINN, discharge appeals)
• Identify complex psychosocial or financial needs and refer to appropriate resources
• Perform utilization reviews and respond to third-party payers with timely, accurate information
• Collaborate with physicians and care teams to align care and discharge plans with patient needs and payer guidelines
• Participate in daily interdisciplinary rounds and serve as a patient advocate
• Ensure seamless transitions of care, including referrals, documentation, and communication with external facilities
• Maintain up-to-date knowledge of community resources and post-acute care options
• Apply clinical pathways and care maps; contribute to their development and updates
• Identify and manage days at risk for denial, and assist in coding and documentation as needed
• Adhere to quality, safety, infection control, and regulatory standards
• Participate in ongoing education, training, and quality initiatives

Qualifications:

• Active RN license in the Commonwealth of Massachusetts
• Bachelor of Science in Nursing (preferred)
• Minimum of 3 years recent acute care experience in a hospital or case management role
• Demonstrated experience in discharge planning and utilization review within the past 4 years
• Working knowledge of InterQual® or equivalent clinical review system
• Case Management certification (CCM, CPUM, or specialty) preferred
• Strong interpersonal, communication, and negotiation skills
• Ability to manage time effectively and work both independently and within a team
• Proficiency with electronic health records and modern healthcare software systems