Case Manager RN

Cooperidge Consulting Firm is seeking a Case Manager Registered Nurse (RN) for a top Healthcare client.

The RN Case Manager (CM) serves as a Care Coordinator, facilitating the interdisciplinary plan of care with a focus evaluating clinical appropriateness, medical necessity, level of care, and resource utilization. This role coordinates activities that promote quality outcomes and efficient patient throughput, identifies barriers to care, and assumes a leadership role in developing effective discharge plans.

• Perform comprehensive assessments of the psychosocial and medical needs of assigned patients to develop a detailed case management plan of care.
• Evaluate admissions for medical necessity and appropriate observation status using approved criteria, escalating issues through the established chain of command as needed.
• Assume a leadership role with the interdisciplinary team to manage care, ensuring appropriate level of care, patient status, and resource utilization are maintained.
• Facilitate patient throughput with an ongoing focus on quality and efficiency, coordinating services necessary to meet identified post‑discharge needs.
• Track and trend variances and barriers to care, making recommendations and developing action plans to improve processes and systems across the continuum.
• Perform utilization management reviews and communicate crucial information to third‑party payors, acting as a liaison between all parties (physicians, hospital staff, outside agencies).
• Ensure compliance with all regulatory requirements, HCA Ethics and Compliance policies, and quality initiatives related to the provision of Case Management Services.
• Document professional recommendations, care coordination interventions, and case management activities accurately to ensure effective communication across the healthcare team.

• Associate's Degree in Nursing or Diploma in Nursing is required.
• Bachelor’s Degree in Nursing is preferred.

• Option 1 (Direct CM):
  Minimum of 3 years of RECENT (within the last year) Case Manager experience in an acute care setting is required.
• Option 2 (Unit Experience):
  Minimum of 3 years of recent RN experience in Med/Surg, Telemetry, Neuro, ICU, PCU, or ED is required.
• Option 3 (Non‑Acute CM):
  Case Manager experience in home health or insurance will be considered, but requires a total of 3 years of acute care experience, with at least 1 year of that acute care experience being within the last 5 years.

• Current FL RN license or appropriate compact licensure is required. If compact, an active FL RN license is required within 90 days of hire.
• Advanced Practice Registered Nurse (APRN) license is acceptable.
• Certification in Case Management, Nursing, or Utilization Review is preferred.

• Proven ability to assume a leadership role with an interdisciplinary team to manage care coordination and resource utilization.
• Strong knowledge of utilization review criteria, regulatory requirements, and discharge planning processes.
• Effective and professional communication skills for acting as a liaison between multiple stakeholders (physicians, payors, families).

• Competitive pay with opportunities for overtime and weekend shifts.
• Comprehensive medical, dental, and vision insurance.
• Life insurance and disability coverage.
• 401(k) retirement plan with employer match.
• Paid time off — vacation, sick leave, and holidays.
• Continuing education and professional development opportunities.
• Supportive, team‑oriented work environment.