RN Case Manager / per-diem

RN Case Manager coordinates, negotiates, and manages care for complex patients as a patient advocate, performing clinical case management, discharge planning, and care coordination to optimize quality and cost-effective outcomes. Uses InterQual criteria to determine medical necessity, communicates with physicians and payers, collaborates with multidisciplinary teams, and supports timely and appropriate discharge planning while maintaining compliance with payor guidelines and regulatory requirements. Responsibilities include reviewing medical records, identifying cases not meeting criteria, notifying physicians about necessary documentation, facilitating utilization management, arranging referrals to appropriate services, and supporting the continuity of care across inpatient and observation settings. Requires RN licensure and CCM/ACM certification within two years of hire; Bachelor's degree strongly preferred; 3-5 years acute care experience and critical care/emergency department experience highly desirable. Proficiency with EHR (Epic, MCCM, MCCM, InterQual) and strong communication, negotiation, and problem-solving skills are essential.