RN Case Manager / per-diem
On-site · Scituate, Massachusetts, United States
Job Summary
RN Case Manager coordinates care for SSH&EC clients with a focus on clinical review, discharge planning, and resource utilization across the continuum. Responsibilities include reviewing medical records to determine medical necessity for admission and continued stay using InterQual Criteria and payer criteria; initiates and coordinates discharge planning; communicates with physicians, payers, and multidisciplinary teams to facilitate timely, cost-effective, high-quality care; monitors and documents patient status, facilitates appropriate utilization, and supports facilities in resource management. The role involves collaboration with interdisciplinary staff, participation in quality improvement, and coverage to meet a minimum of 32 hours with night/weekend shifts in a 4-week schedule; a major summer or winter holiday is also worked. Locations: Scituate, MA. Healthcare technology tools referenced include EHR, InterQual, MCCM, Epic, and Workday.
Required Qualifications
- RN - Registered Nurse
- Minimum Education: Registered Nurse or higher (Bachelor's preferred)
- ACM-Accredited Case Manager or CCM-Certified Case Manager within two years of hire
- 3-5 years acute care hospital experience preferred
- Critical Care or Emergency Department experience highly desirable
- Knowledge of InterQual Criteria, utilization management, discharge planning, and care coordination
- Excellent verbal and written communication skills
- Basic computer skills; experience with EHR systems (eDischarge, InterQual, MCCM, Epic, Workday)
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