Emergency RN Case Manager: Discharge & Care Coordination

South Shore Health; Weymouth (MA); Hybrid; USD 85,000 - 110,000; Full time

Job summary

South Shore Health System in Weymouth, MA is seeking an RN Case Manager to coordinate, negotiate, and procure services for SSH&EC clients under the Case Management Manager. The role emphasizes reviewing medical records for utilization, discharge planning, and cost-effective patient care.

The RN Case Manager collaborates with physicians, nurses, and payers to ensure medical necessity, arrange post-acute care, and support timely transitions across the continuum of care.

Qualifications

• Registered Nurse with a bachelor's degree preferred.
• 3–5 years acute care hospital experience preferred.
• CCM/ACM certification within two years of hire is preferred.

Responsibilities

• Review medical records to ensure appropriate utilization and care.
• Coordinate, negotiate, and procure services for complex patients.
• Discharge planning and care coordination across continuum.
• Communicate with physicians, payers, and care teams to determine medical necessity.
• Identify and arrange referrals to appropriate services and resources.
• Monitor and document patient status and ensure timely discharges.

Skills

Case management

Discharge planning

Care coordination

Interqual criteria

Communication

Education

Registered Nurse

Bachelors preferred

Tools

EHR

InterQual

MCCM

Epic

Workday

Job description

South Shore Health System in Weymouth, MA is seeking an RN Case Manager to coordinate, negotiate, and procure services for SSH&EC clients under the Case Management Manager. The role emphasizes reviewing medical records for utilization, discharge planning, and cost-effective patient care.

The RN Case Manager collaborates with physicians, nurses, and payers to ensure medical necessity, arrange post-acute care, and support timely transitions across the continuum of care.