IntePros
Case Management Nurse
IntePros - Philadelphia, Pennsylvania, United States, 19117
Work at IntePros
Overview
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Overview
MUST reside in PA,NJ, or DE and have an active PA,NJ, or DE RN license
RN Care Management Coordinator – Infusion Therapy Team (Remote) About the Role: Under the guidance of the Care Management and Coordination Supervisor, the RN Care Management Coordinator performs
telephonic or onsite reviews of hospital admissions , ensures appropriate utilization of healthcare resources, and facilitates
early and effective discharge planning . This role is key to driving quality care, promoting efficient use of services, and enhancing patient outcomes. Key Responsibilities: Conduct
utilization management
reviews for inpatient admissions (onsite or remote). Assess the
need for inpatient care , continued stay, and appropriate length of stay using medical criteria software. Coordinate care transitions to the most
appropriate, cost-effective settings
without compromising quality. Collaborate with attending physicians to review treatment plans and
clarify medical necessity . Identify hospital admissions that no longer meet inpatient criteria and present cases to Medical Directors as needed. Evaluate members for
discharge planning needs
early in their hospital stay. Work with hospital staff, physicians, and families to facilitate smooth, timely discharges. Identify cases for
case management or disease management
referrals. Flag quality-of-care concerns and report them to the appropriate departments. Maintain
accurate and timely documentation
in internal systems. Comply with
state, federal, and accreditation standards
in all utilization decisions. Support provider education and build
positive relationships
across the healthcare network. Report trends, utilization issues, and improvement opportunities to leadership. Required Qualifications: Registered Nurse (RN) license
in good standing (BSN preferred). Minimum 3 years
of acute care clinical experience (hospital or similar setting). Experience in
discharge planning
and/or
utilization management
strongly preferred. Valid driver’s license and reliable transportation (for occasional onsite needs). Key Skills: Strong clinical judgment and
problem-solving skills . Excellent
verbal and written communication
across all levels. Highly
organized
with strong documentation and follow-through abilities. Proven ability to
collaborate
effectively with cross-functional teams. Customer-focused and committed to delivering
exceptional service .
RN Care Management Coordinator – Infusion Therapy Team (Remote) About the Role: Under the guidance of the Care Management and Coordination Supervisor, the RN Care Management Coordinator performs
telephonic or onsite reviews of hospital admissions , ensures appropriate utilization of healthcare resources, and facilitates
early and effective discharge planning . This role is key to driving quality care, promoting efficient use of services, and enhancing patient outcomes. Key Responsibilities: Conduct
utilization management
reviews for inpatient admissions (onsite or remote). Assess the
need for inpatient care , continued stay, and appropriate length of stay using medical criteria software. Coordinate care transitions to the most
appropriate, cost-effective settings
without compromising quality. Collaborate with attending physicians to review treatment plans and
clarify medical necessity . Identify hospital admissions that no longer meet inpatient criteria and present cases to Medical Directors as needed. Evaluate members for
discharge planning needs
early in their hospital stay. Work with hospital staff, physicians, and families to facilitate smooth, timely discharges. Identify cases for
case management or disease management
referrals. Flag quality-of-care concerns and report them to the appropriate departments. Maintain
accurate and timely documentation
in internal systems. Comply with
state, federal, and accreditation standards
in all utilization decisions. Support provider education and build
positive relationships
across the healthcare network. Report trends, utilization issues, and improvement opportunities to leadership. Required Qualifications: Registered Nurse (RN) license
in good standing (BSN preferred). Minimum 3 years
of acute care clinical experience (hospital or similar setting). Experience in
discharge planning
and/or
utilization management
strongly preferred. Valid driver’s license and reliable transportation (for occasional onsite needs). Key Skills: Strong clinical judgment and
problem-solving skills . Excellent
verbal and written communication
across all levels. Highly
organized
with strong documentation and follow-through abilities. Proven ability to
collaborate
effectively with cross-functional teams. Customer-focused and committed to delivering
exceptional service .