RN Case Manager / per-diem
On-site · Quincy, Massachusetts, United States
Job Summary
RN Case Manager position in Quincy, MA requiring patient advocacy, case management, and care coordination to ensure cost-effective, high-quality care. Responsibilities include reviewing hospital records for medical necessity using InterQual criteria, coordinating discharge planning, identifying appropriate services across the continuum of care, and communicating with physicians, payers, and multidisciplinary teams. Role emphasizes utilization management, reducing length of stay where appropriate, and ensuring timely admission/ discharge decisions. Requires RN licensure and CCM/ACM certification within two years; 3-5 years acute care hospital experience preferred; in-depth knowledge of discharge planning, payer requirements, and EHR systems (Epic, MCCM). Minimum 32 hours with night/weekend shifts and holidays; eligible for per-diem schedule in a hospital setting.
Required Qualifications
- RN - Registered Nurse license
- ACM-Accredited Case Manager or CCM-Certified Case Manager within two years of hire
- Minimum 3-5 years acute care hospital experience preferred
- Critical Care or Emergency Department experience highly desirable
- Knowledge of InterQual Criteria and utilization management
- Ability to negotiate and coordinate resources
- Strong communication and documentation skills
- Familiarity with EHR systems (Epic, MCCM)
- Knowledge of post-acute care resources and payer requirements
- Discharge planning and care coordination expertise
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