Registered Nurse (RN) - Case Manager

The Registered Nurse (RN) - Case Manager serves as a Utilization Management RN Case Manager, ensuring accurate clinical documentation and regulatory compliance within the healthcare facility. This role involves reviewing patient records, communicating with managed care organizations to secure authorizations, and collaborating with physicians to resolve denial determinations. The position requires proactive care coordination, discharge planning, and adherence to CMS and regulatory requirements to optimize patient outcomes and resource utilization.