RN Case Manager: Care Coordination & Discharge Lead

South Shore Health; United States; In loco; USD 104.000 - 154.000; Part-time

Descrizione del lavoro

South Shore Health is seeking an experienced RN Case Manager in Weymouth, MA to coordinate care for complex patients, ensure medical necessity, and support cost-efficient outcomes across the continuum of care.

You will lead discharge planning, collaborate with physicians, nursing and payors, and advocate for patients and families while navigating InterQual criteria and insurance requirements. This is a part-time, day-shift role with some night/weekend hours.

Competenze

• Licensed Registered Nurse with active license.
• Experience in case management is preferred.
• Familiarity with InterQual criteria and discharge planning processes.

Mansioni

• Review medical records of observation and inpatient admissions to ensure proper utilization.
• Coordinate discharge planning and arrange post-acute services.
• Communicate with physicians regarding medical necessity and documentation requirements.
• Assist with insurance authorizations and associated documentation.
• Collaborate with care teams to optimize patient outcomes across the continuum.

Conoscenze

InterQual criteria

Discharge planning

Care coordination

Clinical documentation

Formazione

RN license

Strumenti

EHR systems

Descrizione del lavoro

South Shore Health is seeking an experienced RN Case Manager in Weymouth, MA to coordinate care for complex patients, ensure medical necessity, and support cost-efficient outcomes across the continuum of care.

You will lead discharge planning, collaborate with physicians, nursing and payors, and advocate for patients and families while navigating InterQual criteria and insurance requirements. This is a part-time, day-shift role with some night/weekend hours.