As a RN Case Manager CM Registered Nurse, your voice to influence patient care is valued and empowered at every turn –whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives. You'll help shape decisions that elevate both patient outcomes and the future of nursing.
The Case Manager’s primary duties are to provide Utilization Review and Case Management functions for the organization under the direction of the Director, Case Management and within the established policies and procedures. He/she performs preadmission, concurrent and retrospective review for all payers; completes assessments for the purpose of identifying discharge-planning needs; and provides discharge-planning services for select patient populations. Must be proficient in Interqual. The Case Manager works with physicians and other members of the multidisciplinary team to develop a plan for each patient from admission to discharge. v Your responsibilities will include:
Performs continuous assessments and evaluations to ensure patient is progressing towards desired outcomes
Assesses and responds to patient/family needs by coordinating efforts of other team members
Identifies and resolves barriers that hinder effective patient care
Collaborates and consults with physicians on patient’s progress and discharge planning needs
Performs utilization review ensuring admissions meet criteria for appropriateness of care and medical necessity
Manages the process to review and, as appropriate, appeal denials received from payers
Coordinates the discharge planning process ensuring involvement of all members of the healthcare team
Counsels with patients and family members in decision making and in meeting psycho social needs of the patient
Maintains knowledge of resources and facilities available to patients and family members
Collaborates with personnel at other facilities to coordinate smooth and effective patient transfers and transitions
Compiles, evaluates, and reports statistics to members of the team and utilizes the information to facilitate process improvement activities
Applies knowledge of the patient population served; proves age-specific care; applies knowledge of expected norms in planning care
Promotes internal and external customer satisfaction
Builds and promotes a culture of service excellence and continuous improvement
Attendance: works as scheduled and is compliant with Attendance and Tardiness Policy
Required: Registered Nurse Licensure
Preferred: Bachelors or Masters of Science in Nursing; knowledge of CMS guidelines and experience working with payer specific guidelines and contractual rules; previous UR or hospital Case Management experience
One to three years of experience in a hospital or health care system
Assertive and persuasive communication skills, action oriented
Catholic Medical Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
"Nurses are essential to the delivery of healthcare and serve as its foundation. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursing’s future."
Erica Rossitto, MBA/HCM, BSN, RN, NEA-BC
Senior Vice President and Chief Nurse Executive
HCA Healthcare
Shape the future of healthcare at Catholic Medical Center.
Located in Manchester, NH, Catholic Medical Center is a 330-bed acute care hospital and Level III Trauma Center serving southern New Hampshire and northern Massachusetts. Home to the nationally recognized New England Heart & Vascular Institute and The Mom’s Place—an innovative birthing center that pioneered couplet care—we’re proud to lead in both advanced medicine and compassionate service.
As part of HCA Healthcare’s statewide network of Catholic Medical Center in Manchester, Portsmouth Regional Hospital, Frisbie Memorial Hospital in Rochester hospitals, three freestanding ERs, and over 70 care sites, you’ll join nearly 5,000 colleagues across New Hampshire who are committed to excellence, collaboration, and making a difference every day. At Catholic Medical Center, your work has purpose—and your potential has no limits.
HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
If this opportunity is your next step in your career path, we encourage you to apply for our RN Case Manager CM Registered Nurse opening. We review all applications. Qualified candidates will be contacted by a member of our team. We are interviewing, apply today!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
At its founding in 1968, Nashville-based HCA was one of the nation's first hospital companies. Today, we are the nation's leading provider of healthcare services, a company comprised of locally managed facilities that includes about 165 hospitals and 115 freestanding surgery centers in 20 states and England and employing approximately 204,000 people. Approximately four to five percent of all inpatient care delivered in the country today is provided by HCA facilities. Richard M. Bracken serves as Chairman of HCA and R. Milton Johnson is the company's President and Chief Executive Officer.
HCA is committed to the care and improvement of human life and strives to deliver high quality, cost effective healthcare in the communities we serve. Building on the foundation provided by our Mission & Values, HCA puts patients first and works to constantly improve the care we give them by implementing measures that support our caregivers, help ensure patient safety and provide the highest possible quality. Investing in our communities is important to us. HCA typically invests about $1.5 billion annually to keep our facilities modern and up-to-date technologically and to expand and add services where needed. Focusing primarily on communities where the company is a leading healthcare provider, HCA selectively adds new facilities in order to better serve our communities.
And because two HCA founders were physicians, we value highly the strong relationships we've created with local physicians. We endeavor to provide them with a wide array of services and modern facilities in order to help them deliver the best possible care.