Travel Case Manager – LPN/RN (Emergency Department) - TCM25
NavitsPartners
- Barnstable, MA
- Contract
- Full-time
Location: Hyannis, MA 02601
Duration: 13 Weeks
Shift: 11:00 AM – 9:30 PM or 11:30 AM – 10:00 PM
Type: ContractPosition Summary:A leading healthcare facility in Hyannis, MA is seeking an experienced Travel Emergency Department Case Manager (LPN or RN) for a 13-week travel assignment. The Case Manager will play a vital role in ensuring high-quality care coordination, discharge planning, and utilization management for patients within the fast-paced ED environment. This role requires a combination of clinical expertise, strong communication skills, and knowledge of insurance protocols to support positive outcomes and continuity of care.Key Responsibilities:Clinical Assessment & Planning:Screen new ED admissions daily for discharge needsComplete and update InterQual® assessments as requiredDetermine Inpatient vs. Observation status and validate appropriatelyIdentify and refer complex psychosocial or financial issuesUtilization Review & Reimbursement:Conduct reviews to ensure efficient resource use and payer complianceInterface with insurance providers to secure authorizations and documentationIssue appropriate payer notices (e.g., HINNs) and assist with appealsDischarge Planning & Coordination:Collaborate with interdisciplinary team to develop safe discharge plansParticipate in ED rounds and maintain timely communicationArrange transfers and referrals, ensuring documentation is completePatient Advocacy & Communication:Act as a liaison for patients and families regarding coverage and care plansSupport patient-centered care and shared decision-makingDocumentation & Compliance:Maintain thorough records in the EHR and according to regulatory standardsWork with coders and documentation specialists to ensure accurate reimbursementsTrack and report days at risk for insurance denialsTeam Support & Development:Stay current with case management protocols and payer guidelinesAttend departmental education, meetings, and contribute to quality initiativesQualifications:Education:Graduate of an accredited nursing program (LPN or RN)Bachelor of Science in Nursing (BSN) preferredLicensure/Certifications:Active and unencumbered Massachusetts LPN or RN licenseCertification in Case Management (CCM, CPUR, CPUM) preferredExperience:3+ years of recent acute care experience in a hospital setting (within past 5 years)2+ years in case management, discharge planning, and utilization reviewFamiliarity with InterQual® or comparable utilization review toolsSkills:Strong written and verbal communicationExcellent organizational and critical thinking skillsProficient in electronic health records (EHRs) and computer systemsAbility to work effectively in a high-acuity, team-based ED environment