RN Care Managmnt Coordinator

Innova Solutions has a client that is immediately hiring for a RN Care Management Coordinator Position type: Full time - Contract Duration: 3 Months Location: Philadelphia, PA As a RN Care Management Coordinator, you will: Responsible for applying critical thinking and judgement skills based on advanced medical knowledge to cases utilizing specified resources and guidelines to make case determination. Utilizes the medical criteria of InterQual and/or Medical Policy to establish the need for inpatient, continued stay and length of stay, procedures and ancillary services. Contacts servicing providers regarding treatment plans/plan of care and clarifies medical need for services. Reviews treatment plans/plan of care with provider for requested services/procedures, inpatient admissions or continued stay, clarifying medical information with provider if needed. Identifies and refers cases in which the plan of care/services are not meeting established criteria to the Medical Director for further evaluation determination. Performs early identification of members to evaluate discharge planning needs. Collaborates with case management staff or physicians to determine alternative settings at times and provide support to facilitate discharge to the most appropriate setting. Appropriately refers cases to the Quality Management Department and/or Care Management and Coordination Manager when indicated to include delays in care. Appropriately refers cases to Case and Disease Management. Ensures utilization decisions are compliant with state, federal and accreditation regulations. Ensures that all key functions are documented via Care Management and Coordination Policy. The ideal candidate will have: PA RN license required. Minimum of three (3) years of acute care clinical experience in a hospital or other health care setting. Preferred skills: Prior discharge planning and/or utilization management experience. Qualified candidates should APPLY NOW for immediate consideration This position is only open to applicants who can be engaged on a W-2 basis. Please hit APPLY to provide the required information, and we will be back in touch as soon as possible. We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW. Thank you Thank you Sac To view the full job description please use the link below.

Created: 2026-02-19