Case Manager RN

PLEASE SEND RESUME TO Sbenson@nri-staffing.comSWB

We are seeking an experienced and compassionate Case Manager to join our team. This is a fully remote position with regular field-based responsibilities, including visits to nursing facilities and provider sites throughout Washington, DC, and Maryland. Candidates who reside within the DMV (DC, Maryland, Virginia) area are strongly preferred due to the travel requirements of the role.

• Perform quality and utilization management reviews to assess residents' ongoing need for services and appropriate acuity levels.
• Ensure care plans and supporting documentation comply with regulatory requirements, including but not limited to PASRR, MDS, Medicare, Medicaid, and other applicable standards.
• Conduct onsite evaluation reviews for provider partners throughout Washington, DC, and Maryland.
• Review admission screenings, continued stay evaluations, and care planning documentation.
• Collaborate with interdisciplinary teams to support quality outcomes and regulatory compliance.
• Maintain accurate and timely documentation in accordance with organizational and regulatory requirements.

This position requires travel to nursing facilities and provider sites in Washington, DC, and Maryland two to three days per week. Candidates living within the DMV area are preferred.

• Demonstrated expertise in Quality Improvement and Utilization Management best practices.
• Ability to organize, prioritize, and coordinate multiple tasks simultaneously in a team-oriented environment.
• Strong knowledge of Medicaid and Medicare evaluation criteria.
• Experience with PASRR, MDS, admission screenings, and continued stay evaluations.
• Familiarity with medical management applications; experience with Jiva is preferred.
• Excellent communication, documentation, and analytical skills.
• Reliable transportation and ability to travel for onsite visits.

• Degree or diploma in Nursing
• Current, active, unrestricted Registered Nurse (RN) license in Washington, DC,
• Minimum of 2 years of direct patient care clinical experience.
• Minimum of 2 years of experience conducting admission screenings and care planning for patients in long-term care facilities.
• At least 1 year of MDS experience or continued stay/utilization review experience preferred.

please send your resume to Sbenson@nri-staffing.com

Look forward to hearing from you.