RN Case Manager: Care Coordinator & Discharge Planner

South Shore Health; Milton (MA); On-site; USD 90,000 - 120,000; Full time

Job summary

South Shore Health is seeking an RN Case Manager to advocate for SSH&EC clients, coordinating services and resources for complex patients to ensure high-quality, cost-efficient outcomes. The role demands on-site work seven days a week, weekend rotation, and occasional holidays.

The RN will review medical records, determine medical necessity using criteria, support discharge planning, and help optimize payer communications while ensuring timely care transitions.

Qualifications

• RN case management with active license.
• CCM/ACM certification within two years of hire preferred or required.
• Strong negotiation and communication skills; experience with utilization management.

Responsibilities

• Review patient records to determine medical necessity for admission and continued stay.
• Coordinate discharge planning and care coordination across the continuum of care.
• Engage with physicians, nurses, and payers to optimize resource use and avoid delays.
• Identify and address barriers to timely discharge and appropriate level of care.
• Perform pre-admission screening and transition planning to ensure smooth patient flow.
• Communicate clearly with patients and families about care plans and options.
• Participate in quality improvement initiatives and maintain regulatory compliance.

Skills

Negotiation

Communication

Interdisciplinary collaboration

Management

Creative problem solving

Time management

Multitasking

Conflict resolution

Education

RN license

Bachelor's degree preferred

Job description

South Shore Health is seeking an RN Case Manager to advocate for SSH&EC clients, coordinating services and resources for complex patients to ensure high-quality, cost-efficient outcomes. The role demands on-site work seven days a week, weekend rotation, and occasional holidays.

The RN will review medical records, determine medical necessity using criteria, support discharge planning, and help optimize payer communications while ensuring timely care transitions.