RN Case Manager / per-diem
On-site · Abington, Massachusetts, United States
Job Summary
RN Case Manager provides patient advocacy, care coordination, discharge planning, and utilization management to ensure cost-effective, high-quality healthcare. Duties include reviewing medical records for observation and inpatient admissions, applying InterQual criteria and payor requirements to determine medical necessity, coordinating services across interdisciplinary teams, arranging prompt and safe discharge, and maintaining timely communications with physicians, payers, and patients. Requires RN licensure; CCM/ACM certification preferred within two years. Strong negotiation, communication, and knowledge of payer processes and post-acute care resources are essential.
Required Qualifications
- RN - Registered Nurse
- ACM-Accredited Case Manager or CCM-Certified Case Manager within two years of hire
- Bachelor's degree strongly preferred
- Minimum 3-5 years acute care hospital experience preferred
- Critical Care or Emergency Department experience highly desirable
Desired Qualifications
- RN licensure in good standing
- ACM-Accredited Case Manager or CCM certification within two years of hire
- Bachelor's degree strongly preferred
- 3-5 years acute care hospital experience preferred
- Critical Care or Emergency Department experience highly desirable
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