RN Case Manager / per-diem
On-site · Kingston, Massachusetts, United States
Job Summary
RN Case Manager role providing clinically-based case management, discharge planning and care coordination for SSH&EC clients. Responsible for reviewing medical records to determine medical necessity for admission and continued stay, coordinating services and resources, negotiating with payors, and guiding timely discharge while maintaining high-quality care. Utilizes InterQual criteria, communicates with physicians and multidisciplinary staff, and supports cost-effective care across the continuum. Requires collaboration with interdisciplinary teams, attention to payer requirements, and proactive management of patient flow. Requires minimum 32 hours with night/weekend shifts across a 4-week schedule; night or weekend coverage and at least one major holiday. Kingston, MA location; per-diem / contract arrangement.
Required Qualifications
- RN - Registered Nurse
- ACM-Accredited Case Manager or CCM-Certified Case Manager within two years of hire
- Minimum 3-5 years acute care hospital experience preferred
- Critical Care or Emergency Department experience highly desirable
- Demonstrated skills in negotiation, communication (verbal and written), conflict, interdisciplinary collaboration, management, creative problem solving, and critical thinking
- Knowledge of healthcare financing, community and organizational resources, patient care processes, and data analysis
- Knowledge of utilization management as it relates to third party payers
- Knowledge of post-acute care community resources
- Experience with Managed Care preferred
- Excellent verbal and written communication skills required
- Demonstrates flexibility via an ability to adapt to changing priorities and regulations
- Basic computer skills required
- Licensure as RN (Registered Nurse)
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