RN Case Manager / per-diem
On-site · Pembroke, Massachusetts, United States
Job Summary
RN Case Manager responsible for reviewing medical records to determine medical necessity, coordinating, negotiating, and procuring services for complex patients, and managing care across observation and inpatient admissions. Leads discharge planning and care coordination to support cost-effective, quality healthcare; utilizes InterQual criteria and payer requirements; communicates with physicians, payers, and interdisciplinary teams to ensure appropriate utilization, timely discharge, and avoidance of unnecessary costs. Position emphasizes clinical data management, documentation, and collaboration across teams with a minimum 32 hours weekly including night and weekend shifts, plus one major holiday season.
Required Qualifications
- RN license
- ACM or CCM certification within two years of hire
- Bachelor's degree strongly preferred (RN)
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