RN Case Manager / per-diem
On-site · Braintree, Massachusetts, United States
Job Summary
RN Case Manager coordinates, negotiates, procures services and resources for SSH&EC clients; provides clinically-based case management, discharge planning and care coordination to facilitate cost-effective quality healthcare; reviews medical records to determine medical necessity for admission and continued stay using InterQual criteria; informs patients and families about insurance requirements and discharge plans; collaborates with interdisciplinary staff; supports quality improvement initiatives; works minimum 32 hours with 2 shifts at night or weekend per 4-week schedule and participates in at least one major holiday; responsibilities include coordinating, documenting, and advocating for timely and appropriate patient care across the continuum of care.
Required Qualifications
- RN - Registered Nurse
- ACM-Accredited Case Manager or CCM-Certified Case Manager within two years of hire
- Minimum education not explicitly stated beyond RN licensure
- Strong negotiation and communication skills
- Experience with InterQual criteria and payor-specific criteria
- Knowledge of discharge planning, care coordination, and utilization management
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