{"schemaVersion":"jobsearcher.job.v1","id":"7aa62d45a7ed345abc4a06ad","url":"https://jobsearcher.com/jobs/7aa62d45a7ed345abc4a06ad","canonicalUrl":"https://jobsearcher.com/jobs/7aa62d45a7ed345abc4a06ad","title":"Case Manager","description":"*Job Title:* RN Inpatient Care Coordinator / Utilization Management\n*Job Type:* Contract\n*Contract Duration:* 13 Weeks\n*Start Date:* October 5, 2026\n*Schedule:* Day Shift\n*Specialty:* Nursing – Care Management\nThe pay rate for a local candidate is *$10 less than the rate offered to a travel candidate*\n\nPosition Overview\n\nWe are seeking an experienced *Registered Nurse (RN) Inpatient Care Coordinator* to manage patient progression of care, utilization review, care coordination, and discharge planning.\n\nThe ideal candidate will have extensive clinical nursing experience with strong expertise in *chart review, utilization management, risk management, quality services, and inpatient care coordination*. This role works closely with physicians, clinical leadership, patients, families, payers, and multidisciplinary teams to ensure appropriate, timely, and cost-effective care.\n\nKey Responsibilities\n\n* Manage and monitor the progression of care for hospitalized patients.\n* Review patient medical records and evaluate clinical progress.\n* Conduct ongoing utilization review to assess *medical necessity, level of care, length of stay, and quality of care*.\n* Review new hospital admissions and assess patient conditions and care needs.\n* Develop and support individualized treatment and discharge plans.\n* Review and validate physician orders, treatment plans, reports, and clinical documentation.\n* Collaborate with physicians, hospital leadership, and multidisciplinary clinical teams.\n* Ensure patient care meets hospital, regulatory, and payer requirements.\n* Communicate with insurance companies and payers within required timeframes.\n* Review medical records and obtain required reports for regulatory agencies and payers.\n* Provide patients and families with information regarding healthcare benefits when appropriate.\n* Maintain accurate Utilization Management, Care Management, Discharge Planning, and appeal documentation.\n* Process requests for appeals and respond to complaints according to established guidelines.\n* Maintain utilization review and appeal logs.\n* Support quality improvement initiatives through clinical and utilization reviews.\n* Assist with Purchased/Referred Care Services patients receiving care at outside facilities.\n* Provide education and guidance to physicians and departments regarding utilization management regulations.\n* Prepare notification letters and required information for providers, staff, and patients.\n* Perform tumor registry functions as assigned.\n* Perform other duties as assigned.\n\nRequired Qualifications\n\n* *Bachelor’s Degree in Nursing (BSN)* required.\n* *Active Alaska RN license is mandatory at the time of submission.*\n* Agency/travel candidates must have an *active Alaska nursing license*.\n* Minimum *8 years of clinical care or nursing experience*.\n* At least *3 years of experience in chart review, risk management, utilization management, or related quality services*.\n* Strong knowledge of medical terminology, anatomy, physiology, and disease processes.\n* Knowledge of medical necessity and level-of-care review.\n* Knowledge of public and private insurance reimbursement requirements.\n* Understanding of *CMS (Centers for Medicare & Medicaid Services)* regulations.\n* Basic knowledge of *ICD-9 and CPT coding*.\n* Strong written and verbal communication skills.\n* Excellent organizational and analytical skills.\n\nPreferred Qualifications\n\n* *Case Management certification* from a recognized organization such as *CCM/CCMC or NCQA* preferred.\n* Previous experience in *Utilization Review (UR), Utilization Management (UM), Case Management, Discharge Planning, or Care Coordination* preferred.\n* Experience working with hospital-based multidisciplinary teams preferred.\n\nCompliance Requirements\n\n* *Active Alaska RN license required at submission.*\n* *Flu vaccination required.*\n* Fingerprint cards are required for background clearance.\n* After acceptance, the traveler must schedule fingerprinting and mail the fingerprint cards to *SEARHC in Juneau within 2–3 days*.\n* The start date will be *no less than 6 weeks after SEARHC receives the fingerprint cards* for processing.\n* Delays in submitting fingerprints may result in the start date being pushed back.\n\nPay: $84.00 - $88.00 per hour\n\nEducation:\n* Bachelor's (Required)\n\nExperience:\n* clinical care or nursing experience.: 8 years (Required)\n* chart review, risk management, utilization management: 3 years (Required)\n* hospital-based multidisciplinary teams : 2 years (Preferred)\n\nLicense/Certification:\n* Active Alaska RN license (Required)\n* Case Management certification (Preferred)\n\nWork Location: In person","company":"Codinix","rawCompany":"codinix","city":"Sitka","state":"AK","isRemote":false,"isActive":false,"createdAt":"2026-08-19T19:26:55.350Z","occupations":[{"code":"29-1141.00","title":"Registered Nurses","slug":"registered-nurses"},{"code":"29-1141.04","title":"Clinical Nurse Specialists","slug":"clinical-nurse-specialists"},{"code":"29-1141.01","title":"Acute Care Nurses","slug":"acute-care-nurses"}],"industries":[{"code":"622110","title":"General Medical and Surgical Hospitals","slug":"general-medical-and-surgical-hospitals"},{"code":"622310","title":"Specialty (except Psychiatric and Substance Abuse) Hospitals","slug":"specialty-except-psychiatric-and-substance-abuse-hospitals"},{"code":"623110","title":"Nursing Care Facilities (Skilled Nursing Facilities)","slug":"nursing-care-facilities-skilled-nursing-facilities"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Case Manager","description":"*Job Title:* RN Inpatient Care Coordinator / Utilization Management\n*Job Type:* Contract\n*Contract Duration:* 13 Weeks\n*Start Date:* October 5, 2026\n*Schedule:* Day Shift\n*Specialty:* Nursing – Care Management\nThe pay rate for a local candidate is *$10 less than the rate offered to a travel candidate*\n\nPosition Overview\n\nWe are seeking an experienced *Registered Nurse (RN) Inpatient Care Coordinator* to manage patient progression of care, utilization review, care coordination, and discharge planning.\n\nThe ideal candidate will have extensive clinical nursing experience with strong expertise in *chart review, utilization management, risk management, quality services, and inpatient care coordination*. This role works closely with physicians, clinical leadership, patients, families, payers, and multidisciplinary teams to ensure appropriate, timely, and cost-effective care.\n\nKey Responsibilities\n\n* Manage and monitor the progression of care for hospitalized patients.\n* Review patient medical records and evaluate clinical progress.\n* Conduct ongoing utilization review to assess *medical necessity, level of care, length of stay, and quality of care*.\n* Review new hospital admissions and assess patient conditions and care needs.\n* Develop and support individualized treatment and discharge plans.\n* Review and validate physician orders, treatment plans, reports, and clinical documentation.\n* Collaborate with physicians, hospital leadership, and multidisciplinary clinical teams.\n* Ensure patient care meets hospital, regulatory, and payer requirements.\n* Communicate with insurance companies and payers within required timeframes.\n* Review medical records and obtain required reports for regulatory agencies and payers.\n* Provide patients and families with information regarding healthcare benefits when appropriate.\n* Maintain accurate Utilization Management, Care Management, Discharge Planning, and appeal documentation.\n* Process requests for appeals and respond to complaints according to established guidelines.\n* Maintain utilization review and appeal logs.\n* Support quality improvement initiatives through clinical and utilization reviews.\n* Assist with Purchased/Referred Care Services patients receiving care at outside facilities.\n* Provide education and guidance to physicians and departments regarding utilization management regulations.\n* Prepare notification letters and required information for providers, staff, and patients.\n* Perform tumor registry functions as assigned.\n* Perform other duties as assigned.\n\nRequired Qualifications\n\n* *Bachelor’s Degree in Nursing (BSN)* required.\n* *Active Alaska RN license is mandatory at the time of submission.*\n* Agency/travel candidates must have an *active Alaska nursing license*.\n* Minimum *8 years of clinical care or nursing experience*.\n* At least *3 years of experience in chart review, risk management, utilization management, or related quality services*.\n* Strong knowledge of medical terminology, anatomy, physiology, and disease processes.\n* Knowledge of medical necessity and level-of-care review.\n* Knowledge of public and private insurance reimbursement requirements.\n* Understanding of *CMS (Centers for Medicare & Medicaid Services)* regulations.\n* Basic knowledge of *ICD-9 and CPT coding*.\n* Strong written and verbal communication skills.\n* Excellent organizational and analytical skills.\n\nPreferred Qualifications\n\n* *Case Management certification* from a recognized organization such as *CCM/CCMC or NCQA* preferred.\n* Previous experience in *Utilization Review (UR), Utilization Management (UM), Case Management, Discharge Planning, or Care Coordination* preferred.\n* Experience working with hospital-based multidisciplinary teams preferred.\n\nCompliance Requirements\n\n* *Active Alaska RN license required at submission.*\n* *Flu vaccination required.*\n* Fingerprint cards are required for background clearance.\n* After acceptance, the traveler must schedule fingerprinting and mail the fingerprint cards to *SEARHC in Juneau within 2–3 days*.\n* The start date will be *no less than 6 weeks after SEARHC receives the fingerprint cards* for processing.\n* Delays in submitting fingerprints may result in the start date being pushed back.\n\nPay: $84.00 - $88.00 per hour\n\nEducation:\n* Bachelor's (Required)\n\nExperience:\n* clinical care or nursing experience.: 8 years (Required)\n* chart review, risk management, utilization management: 3 years (Required)\n* hospital-based multidisciplinary teams : 2 years (Preferred)\n\nLicense/Certification:\n* Active Alaska RN license (Required)\n* Case Management certification (Preferred)\n\nWork Location: In person","datePosted":"2026-08-19T19:26:55.350Z","dateModified":"2026-08-19T19:26:55.350Z","hiringOrganization":{"@type":"Organization","name":"Codinix","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Sitka","addressRegion":"AK","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"7aa62d45a7ed345abc4a06ad"},"url":"https://jobsearcher.com/jobs/7aa62d45a7ed345abc4a06ad"}}