Travel RN – Case Management Specialist - CCMA

Job Title: Travel RN – Case Management Specialist

Location: Hyannis, MA
Assignment Type: Travel Contract
Duration: 13 Weeks
Shift: Monday to Friday | 8:00 AM – 4:30 PM
Weekly Compensation: $2,762 – $2,890

Overview:

Seeking a skilled Travel RN with expertise in case management to support patient-centered care coordination in a hospital setting. This role ensures safe transitions, cost-efficient outcomes, and collaborative planning across the care continuum.

Key Responsibilities:

• Evaluate new admissions for discharge planning needs
• Perform assessments and reassessments using InterQual® standards
• Review medical necessity of admissions and escalate concerns per protocol
• Handle payer communication, appeals, and notifications such as HINN
• Coordinate services for patients with complex social or financial challenges
• Assist with third-party documentation and authorization reviews
• Align clinical and discharge plans with patient/payer requirements
• Attend and contribute to daily interdisciplinary care rounds
• Facilitate patient transfers and post-discharge coordination
• Maintain knowledge of community and long-term care resources
• Help develop and apply clinical pathways to streamline care
• Mitigate risks of denials by proactively reviewing case progress
• Comply with safety, regulatory, and quality guidelines

Qualifications:

• Active MA RN license
• BSN preferred
• 3+ years recent acute hospital or case management experience
• Familiarity with InterQual® or similar review tools
• Case management certification preferred (e.g., CCM)
• Strong communication and critical thinking skills
• Experience with EHR systems