RN Case Manager / per-diem
On-site · Abington, Massachusetts, United States
Job Summary
RN Case Manager coordinates care for SSH&EC clients under Case Management supervision, reviewing medical records using InterQual criteria to determine medical necessity for observation/admission, performing discharge planning and care coordination to ensure high-quality, cost-effective care. The role collaborates with interdisciplinary staff, participates in quality improvement, and actively manages patient status and transitions across the continuum, including identifying resources, arranging referrals, and communicating with physicians and payers. The position commits to a minimum 32 hours with at least 16 hours in night and/or weekend shifts over a 4-week schedule and includes one major holiday; requires strong negotiation, communication, and problem-solving skills, with emphasis on utilization management, documentation, and discharge planning using tools like InterQual, EHR (Epic), and MCCM.
Required Qualifications
- RN license
- ACM or CCM certification within two years of hire
- Minimum Education: RN preferred; Bachelor's degree strongly preferred (as applicable)
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