RN Case Manager / per-diem

RN Case Manager coordinates and manages care for complex patients, driving discharge planning and resource utilization while collaborating with interdisciplinary teams to ensure quality and cost-effective care. Responsibilities include reviewing medical records for observation and admission status, determining medical necessity using InterQual and payer criteria, coordinating and expediting discharge planning, contacting physicians to clarify documentation, ensuring timely communication with payers and patients, and supporting case management across the continuum of care. Requires ongoing documentation, care coordination, patient advocacy, and utilization management to optimize outcomes; emphasizes negotiation, interdisciplinary collaboration, and knowledge of payer requirements. Requires current RN licensure and relevant case management certifications (ACM CCM) within two years of hire, with strong preference for Bachelor’s-prepared candidates and 3-5 years of acute hospital experience, including Critical Care or Emergency Department exposure.