Registered Nurse (RN) – Case Manager - RNCMST

Location: Syracuse, NY

Position Overview:

"Navitas Healthcare, LLC" is seeking an experienced Registered Nurse Case Manager to coordinate patient care, support utilization management activities, and ensure appropriate level-of-care determinations. The ideal candidate will have strong clinical assessment skills, experience with hospital admissions and discharge planning, and knowledge of healthcare payer requirements and regulatory guidelines.

Key Responsibilities:

• Coordinate and manage patient care throughout the continuum of care
• Conduct clinical reviews and assess appropriate levels of care
• Collaborate with physicians, nursing staff, patients, and families to develop care plans
• Assist with utilization management and utilization review activities
• Apply level-of-care screening criteria such as MCG or InterQual
• Monitor patient progress and coordinate discharge planning
• Interface with healthcare payers, insurance providers, and regulatory agencies
• Ensure compliance with CMS regulations and hospital policies
• Maintain accurate documentation using EPIC EMR
• Advocate for patients while promoting efficient use of healthcare resources

Preferred Experience:

• Utilization Management (UM) or Utilization Review (UR)
• MCG or InterQual level-of-care criteria
• CMS regulations related to hospital admissions
• Working with healthcare payers and regulatory agencies
• Case Management in an acute care setting

Requirements:

• Active New York State RN License
• Current BLS Certification
• Minimum 1.5 years of recent acute care experience within the last 2 years
• Experience in hospitals of similar or greater size preferred
• EPIC EMR experience preferred
• Strong communication, organizational, and critical thinking skills
• Ability to work independently and collaboratively with interdisciplinary teams
• Must pass background screening, drug screening, and health clearance requirements

For more details reach at sthakur@navitashealth.com

We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.