Case Manager / Utilization Review Nurse (RN)

The Case Manager / Utilization Review Nurse coordinates patient care progression, discharge planning, and utilization review activities to ensure appropriate levels of care and regulatory compliance. This role serves as a liaison between patients, families, providers, and payers to facilitate safe, timely, and cost-effective transitions of care. The position combines clinical case management functions with medical necessity reviews and authorization management to support hospital reimbursement integrity.