Registered Nurse (RN) - Case Management - $30-41 per hour New

Lee Health is seeking a Registered Nurse (RN) Case Management for a nursing job in Cape Coral, Florida.

Job Description & Requirements

• Specialty: Case Management
• Discipline: RN
• Duration: Ongoing
• 36 hours per week
• Shift: 12 hours, days
• Employment Type: Staff

Location:Cape Coral Hospital -636 Del Prado BlvdCape Coral FL 33990

Department: Utilization Management - Corporate

Work Type: Full Time

Shift: Shift 2/8:00:00 AM to 8:00:00 PM

Minimum to Midpoint Pay Rate:$30.27 - $40.86 / hour

Summary

Are you detail-oriented and passionate about ensuring high-quality, cost-effective care? Were seeking a Utilization Management Nurse who will play a key role in optimizing patient outcomes, maintaining compliance, and supporting appropriate resource use across the continuum of care.

The Utilization Management Nurse is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. This role ensures compliance with regulatory standards and payer requirements while promoting accurate, concurrent clinical documentation that reflects the patients care and supports reimbursement.

Key Responsibilities:

• Review clinical documentation to determine medical necessity and appropriate level of care using established criteria

• Ensure timely, accurate utilization reviews and documentation to support reimbursement and regulatory compliance

• Collaborate with physicians, nursing staff, and case managers to clarify clinical information and support appropriate care planning

• Monitor patient progress and facilitate transitions across levels of care as needed

• Support concurrent documentation efforts to ensure the medical record reflects the full scope of care and services delivered

• Meet or exceed established productivity and quality benchmarks for utilization review and documentation accuracy

Why Join Us:

• Be part of a collaborative, high-performing utilization management team

• Play a vital role in improving care quality and resource stewardship

• Access ongoing education and leadership opportunities

• Competitive salary and comprehensive benefits

Help us make sure every patient gets the right care at the right timefor the right reasons. Join our Utilization Management team and make a meaningful impact every day.

Requirements

Education: Graduate of an accredited school of professional nursing required. BSN or BS in a related healthcare field, or able to obtain within the first year of hire.

Experience: Minimum of 3 years acute care hospital clinical experience or equivalent utilization management experience within 2 years with a focus on acute care.

Certification: Case Management certification, ACM, CCM, CMCN or NACCM required after 3 yrs. employment (time exception provided for unsuccessful attempts).

License: Currently licensed as an RN in the State of Florida.

Other: Communication and interpersonal skills, basic computer, analytical, grammar and spelling skills. Ability to effectively multi-task responsibilities.

US:FL:Cape Coral

Lee Health Job ID #7​2​1​0​5. Posted job title: Utilization Management Case Manager

About Lee Health Lee Health is one of the largest public health systems in the U.S. and one of the largest not-for-profit public health system and Safety Net Hospital in Florida that receives no direct tax support. Benefits

• Employee assistance programs
• Wellness and fitness programs
• Medical benefits
• Dental benefits
• Vision benefits
• Pet insurance
• Life insurance
• Discount program