Full employer posting
Piedmont Atlanta Hospital is seeking an experienced RN Case Manager to coordinate patient care, manage discharge planning, and ensure appropriate utilization of healthcare services. The ideal candidate will have strong acute-care case management experience and knowledge of Medicare regulations.
Assess patients and develop, implement, and evaluate discharge plans. Coordinate care and services to ensure appropriate levels of care. Monitor patient progress, length of stay, and barriers to discharge.
Perform utilization review and medical necessity assessments. Apply InterQual criteria and/or Milliman guidelines. Conduct concurrent reviews, continued-stay reviews, and retrospective reviews.
Support appeals and denials processes. Follow Medicare requirements, including patient choice, IMM notices, and MOON notices. Collaborate with the interdisciplinary healthcare team to ensure safe and timely transitions of care.
Minimum 3 years of RN Case Management experience. Previous travel assignment experience required; first-time travelers are not accepted. Active Georgia RN license or compact RN license required at submission.
Current BLS certification required. Experience with acute-care case management and discharge planning. Knowledge of utilization review, Medicare regulations, and medical necessity criteria.
Ability to float within the facility and work within the scope of practice. Additional Details: Patient population: Adults and geriatrics. Weekend shifts: None.
On-call: None. Local candidates accepted at the same rate. RTO: Maximum 7 days per contract; all requests must be finalized at submission.
Full compliance is required before the start date.