RN Case Manager / per-diem
On-site · Marshfield, Massachusetts, United States
Job Summary
RN Case Manager responsible for clinically-based case management, discharge planning, and care coordination to optimize quality and cost-effective outcomes. Collaborates with interdisciplinary teams, applies criteria to determine medical necessity for admission and continued stay, and facilitates timely discharge planning. Role includes reviewing medical records, identifying cases that require review, coordinating services, notifying physicians of coverage decisions, and ensuring appropriate utilization across the continuum of care. Requires strong negotiation, communication, and problem-solving skills, ongoing documentation, and knowledge of healthcare financing, payer guidelines, and InterQual criteria. Must maintain licensure and relevant certifications (ACM/CCM) and stay adept with EHR/clinical tools (eDischarge, EHR, Epic). Minimum 32-hour commitment with schedule includes night/weekend shifts and one major holiday per period; Bachelor's-prepared and RN licensure are emphasized throughout, with preferred 3-5 years of acute care hospital experience and CCM/ACM certification.
Required Qualifications
- RN - Registered Nurse
- ACM-Accredited Case Manager or CCM-Certified Case Manager within two years of hire
- Bachelor's degree strongly preferred or higher
- 3-5 years acute care hospital experience preferred
- Critical Care or Emergency Department experience highly desirable
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