RN Case Manager / per-diem
On-site · Duxbury, Massachusetts, United States
Job Summary
RN Case Manager coordinates and advocates for complex patient care across the continuum, performing clinically-based case management, discharge planning, and care coordination under case management leadership. The role reviews medical necessity using InterQual criteria, collaborates with an interdisciplinary team to ensure timely, cost-efficient, high-quality outcomes, communicates with physicians and payers, arranges referrals and transitions of care, and actively supports documentation, resource utilization, and quality improvement initiatives. The position requires coordinating with physicians, nursing staff, and external payers to facilitate appropriate admission, continued stay, and discharge planning, while maintaining patient-centered care and regulatory compliance. The role includes night/weekend coverage, and participation in interdepartmental processes to optimize LOS and patient outcomes.
Required Qualifications
- RN - Registered Nurse
- ACM-Accredited Case Manager or CCM-Certified Case Manager within two years of hire
- 3-5 years acute care hospital experience preferred
- Critical Care or Emergency Department experience highly desirable
- Demonstrated skills in negotiation, communication, conflict management, interdisciplinary collaboration, management, creative problem solving, time management, multitasking in high-stress environment
- Knowledge of InterQual criteria, utilization management, payer requirements, discharge planning, post-acute care resources
- Licensure to practice nursing in appropriate state
- CEU credits and ongoing professional development requirements
- Ability to work night/weekend shifts as described
This role has closed. Sorce can match you with similar open roles and apply on your behalf.
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.