Job Description

RN Case Manager / Utilization Review (Inpatient)

Location: Brooklyn, NY 11212

Shift: Days, Monday–Friday 8:00 AM–4:00 PM; every other Saturday required (8:00 AM–4:00 PM)

Guaranteed Hours: 40/week

Contract Length: ~13 weeks

Position Summary:

RN Case Manager responsible for coordinating inpatient care, utilization management, and discharge planning. The role focuses on concurrent review, high-risk patient identification, collaboration with physicians and interdisciplinary teams, and communication with third-party payers to ensure appropriate level of care and timely discharge.

Key Responsibilities:

• Perform concurrent utilization and continued-stay reviews
• Identify high-risk patients and develop discharge plans for uncomplicated cases
• Coordinate with physicians to establish and update time-oriented plans of care
• Communicate clinical information to third-party payers and complete retro reviews
• Monitor delays, duplication of services, and appropriateness of care
• Collaborate with social work and interdisciplinary teams to facilitate discharge
• Ensure accurate documentation and participation in quality and performance improvement activities

Requirements:

• Active New York State RN license
• BSN required
• Minimum 3 years of direct patient care experience
• BLS and ACLS required
• Strong utilization review, discharge planning, and interdisciplinary collaboration skills

Preferred:

• MSN
• CCM (Certified Case Manager)
• PALS

Pride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts.

Best Regards,

Tabish Ahmad

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