RN, Acute Care Case Manager (Healthcare)

Location: Nashua, New Hampshire, United States

Company

hirify.global provides hospital and multispecialty healthcare services through Southern New Hampshire Medical Center and Foundation Medical Partners in southern New Hampshire and northern Massachusetts.

What you will do

• Evaluate patients’ health status, caregiver capabilities, support systems, and care needs to support safe discharge planning.
• Develop and coordinate multidisciplinary, culturally appropriate, and age-specific discharge plans and care transitions.
• Perform utilization reviews, assess medical necessity, and determine appropriate levels of care using InterQual or comparable criteria.
• Conduct concurrent clinical reviews, communicate with insurance providers, support authorizations and appeals, and help prevent denials.
• Coordinate discharge planning meetings and interdisciplinary care huddles with physicians, nurses, therapists, social workers, patients, families, and community agencies.
• Provide post-discharge resources, support patient and family choice of agencies or facilities, ensure regulatory compliance, and participate in quality improvement initiatives.

Requirements

• Bachelor’s degree in Nursing, or seven years of case management-related healthcare experience as a substitution.
• Current Registered Nurse licensure in the State of New Hampshire is required.
• Three to five years of case management-related healthcare experience.
• Knowledge of care coordination principles and practices, with the ability to achieve competency in abuse reporting, guardianship, discharge planning, community resource referrals, and utilization review.
• Excellent written and verbal communication, analytical thinking, critical decision-making, and interdisciplinary collaboration skills.
• Proficiency with Microsoft Office and the ability to manage competing priorities in a fast-paced healthcare environment.

Nice to have

• Case Manager Certification.
• Experience with InterQual, MCG, Milliman, or other acute-care criteria.
• Acute-care utilization review or discharge planning experience.

Culture & Benefits

• Full-time position with a first shift schedule and 32 hours per week.
• Health, dental, prescription, and vision coverage.
• Life insurance, short- and long-term disability coverage, and flexible spending accounts.
• 403(b) retirement savings plan and competitive pay.
• Tuition reimbursement, nursing student loan paydown, paid training, and education courses for career progression.
• Work in a five-time Magnet-designated hospital focused on high-quality, compassionate care.