RN Case Manager / per-diem

The RN Case Manager coordinates, negotiates, procures services and resources, and manages care for complex patients to optimize quality and cost-effective outcomes. Responsibilities include reviewing medical records for appropriate utilization, determining medical necessity for admission and continued stay using InterQual criteria, facilitating discharge planning, coordinating with multidisciplinary teams, and communicating with physicians, payers, and families. The role emphasizes care coordination, resource utilization, and ensuring timely discharge planning, with heavy emphasis on documentation, collaboration, and adherence to payer guidelines. Requires strong negotiation, communication, and critical thinking skills, RN licensure, and case-management certification (ACM/CCM preferred within two years). Minimum 3-5 years acute care hospital experience preferred; CCU/ED experience desirable.