RN Case Manager: Care Coordination & Discharge Expert

South Shore Health; Boston (MA); On-site; USD 80,000 - 110,000; Full time

Job summary

South Shore Health is seeking an RN Case Manager to coordinates, negotiates, and procures services for complex patients to improve outcomes and optimize costs. The on-site role requires collaboration with interdisciplinary teams and availability seven days a week, including weekends and some holidays.

The RN Case Manager reviews records, uses InterQual criteria, and supports discharge planning and post-discharge coordination with payers.

Qualifications

• RN with active license in good standing
• 3–5 years acute care hospital experience preferred
• CCM/ACM certification preferred or within 2 years of hire
• Experience with utilization management and discharge planning is essential

Responsibilities

• Review patient records to ensure appropriate utilization and level of care
• Coordinate, negotiate, and arrange services for complex patients
• Discharge planning and care coordination across continuum of care
• Collaborate with physicians, nurses, social workers, and payers
• Provide timely communication to patients and families regarding care plans and status
• Support quality improvement initiatives related to case management

Skills

Negotiation

Communication

Critical thinking

Interdisciplinary collaboration

Time management

Education

Bachelor's degree in Nursing

ACM/CCM certification

Tools

InterQual

Epic/EHR

Job description

South Shore Health is seeking an RN Case Manager to coordinates, negotiates, and procures services for complex patients to improve outcomes and optimize costs. The on-site role requires collaboration with interdisciplinary teams and availability seven days a week, including weekends and some holidays.

The RN Case Manager reviews records, uses InterQual criteria, and supports discharge planning and post-discharge coordination with payers.