Case Manager/Utilization Reviewer
Are you a dedicated, motivated healthcare professional with a passion for patient care? Join our team as a Case Manager/Utilization Reviewer and play a pivotal role in collaborating with the interdisciplinary patient care team to coordinate and oversee the plan of care for our patient population. If you thrive in a supportive, collaborative environment and truly enjoy helping others, we want to hear from you!
About Speare Memorial Hospital
Speare Memorial Hospital is a 25-bed critical access hospital serving dozens of communities in the Lakes Region. We are passionately committed to providing exceptional, local care to our friends, families, neighbors, and communities at large.
Mission: To work together to serve the needs of our patients and community.
Vision: A community where all can achieve optimal health.
Values: Kindness, Collaboration, Patient & Family-Centered, Safety, Excellence, Efficiency, and Professionalism.
What You’ll Do:
- Case Management:
- Coordinate the in-patient’s plan of care in collaboration with physicians, nurses, and other members of the health care team, as well as coordinate the multidisciplinary discharge planning meetings to evaluate and identify potential and actual discharge planning needs, coordinating referrals and arrangements for discharge as necessary
- Provide support as needed to the Emergency Department for admission guidance and community resources
- Document pertinent information and status of discharge arrangements in the medical record
- Utilization Review:
- Review hospital resources for utilization and appropriateness, with monitoring for severity of illness and intensity of service in defining appropriate level of care, potential alternatives to acute setting and efficiency with which services are rendered.
- Monitor length of stay in conjunction with screening criteria, length of stay guidelines, patient status and physicians discharge criteria
- Communicate with payers, notifying of admissions, and provision of medical information to determine level of care and/or continued stay approval
- Monitor compliance with CMS regulations
What We’re Looking For:
Required:
- Graduate of an accredited School of Nursing
- Minimum of two years’ previous nursing experience in acute care setting
- Registered Nurse with valid NH state license
- BLS certification
- Excellent assessment, problem-solving, communication, interpersonal, and documentation skills
- Flexibility
Preferred:
- Bachelor’s of Nursing or higher
- In-patient critical care experience
- Experience communicating with third-party payers
- Certified in a relevant specialty
Why Join Speare Memorial Hospital?
- Community Connection: Be part of an organization deeply invested in local health and wellness.
- Collaborative Culture: Work alongside dedicated professionals who genuinely care about their work and each other.
- Professional Growth: Opportunities for continuing education and career development.
- Comprehensive Benefits:
- Competitive salary
- Health, dental and vision insurance
- Health savings accounts with employer contributions
- 403(b) retirement plans with generous employer contributions
- Lifestyle Savings Account reimbursement program
- Tuition Assistance and Student Loan Repayment programs
- Employee recognition and appreciation programs
- Generous Earned Time accrual
- Short-Term & Long-Term Disability
- Life insurance
Our Commitment
Speare Memorial Hospital is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that a diverse workforce strengthens our ability to serve our equally diverse community.
Join us in our mission to provide compassionate, high-quality healthcare to our community.
