Registered Nurse - Case Management/UR/CDI

FSN is seeking an experienced and detail-oriented Registered Nurse (RN) to join our Case Management, Utilization Review (UR), and Clinical Documentation Improvement (CDI) team.

This role is responsible for coordinating patient care, optimizing resource utilization, ensuring appropriate level of care, and improving clinical documentation accuracy. The RN will collaborate with interdisciplinary teams to enhance patient outcomes, ensure regulatory compliance, and support efficient hospital operations.

Key Responsibilities

• Conduct comprehensive patient assessments to support care coordination and discharge planning.
• Perform utilization review (UR) to ensure appropriate level of care and medical necessity.
• Collaborate with physicians and providers to improve clinical documentation accuracy and completeness (CDI).
• Facilitate timely transitions of care, including discharge planning and post-acute referrals.
• Review patient charts to ensure compliance with payer guidelines (Medicare, Medicaid, commercial insurers).
• Communicate with insurance providers regarding authorizations and continued stay reviews.
• Identify and address barriers to discharge and care progression.
• Monitor length of stay and resource utilization to ensure efficiency.
• Educate clinical staff on documentation best practices and regulatory requirements.
• Maintain accurate documentation in electronic health record (EHR) systems.
• Ensure compliance with hospital policies, CMS guidelines, and regulatory standards.

Qualifications:

• Current and valid Registered Nurse (RN) license
• Graduate of an accredited nursing program (BSN)
• 2+ years of clinical nursing experience in a hospital setting (acute care preferred).
• Strong knowledge of care coordination, discharge planning, and healthcare systems.
• Excellent analytical, organizational, and communication skills.
• Experience working with payers and prior authorizations.
• Familiarity with EHR and case management software systems.

Shift & Schedule:

• All shifts available

Benefits & Perks:

• Competitive weekly pay via direct deposit.
• Comprehensive medical, dental, and vision insurance options.
• Retirement savings plans and additional supplemental benefits.
• Paid sick leave in accordance with applicable laws.
• Reimbursement for licensure, certifications, travel, and other eligible expenses.
• Opportunities for ongoing professional development and specialized training.
• Dedicated support team committed to your success.
• Employee referral bonuses and various perks designed to enhance your work experience.

FSN is an Equal Opportunity Employer (EEO) and welcome qualified candidates of all backgrounds, including protected veterans and individuals with disabilities, to apply.