RN Case Manager / per-diem
On-site · Quincy, Massachusetts, United States
Job Summary
RN Case Manager position in an acute-care hospital setting. Responsible for clinically-based case management, discharge planning, and care coordination to ensure quality, cost-efficient patient outcomes. Duties include reviewing medical records for medical necessity using InterQual and payer criteria, identifying cases that require secondary review, coordinating with physicians and interdisciplinary teams to determine appropriate status and level of care, and facilitating safe and timely discharge planning. Employee commits to a minimum of 32 hours with at least 16 hours in night and/or weekend shifts every 4 weeks and one major holiday. Requires strong knowledge of utilization management, third-party payers, and post-discharge resources, plus proficiency with EHR systems (eDischarge, EHR, InterQual, MCCM, Epic, Workday). Must maintain nursing licensure and case management certifications. Proactive communicator with patients, families, payers, and providers; adept at navigating barriers to discharge and coordinating resources for continuum-of-care planning.
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 Work Experience: 3-5 years acute care hospital experience preferred
- Critical Care or Emergency Department experience highly desirable
- Required Licenses / Registrations: RN - Registered Nurse
- Required Certifications: CCM/ACM within two years of hire
- Demonstrated skills in negotiation, communication, conflict management, interdisciplinary collaboration, and critical thinking
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