Travel RN - Case Management Specialist - CCMA Job at NavitsPartners, Worcester, MA

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  • NavitsPartners
  • Worcester, MA

Job Description

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

Job Tags

Contract work, Shift work, Monday to Friday,

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