RN Case Manager - Discharge & Care Coordination

South Shore Health; Braintree (MA); On-site; USD 85,000 - 100,000; Full time

Job summary

South Shore Health seeks an experienced RN Case Manager to advocate for SSH&EC clients, coordinate services, and ensure quality, cost-efficient care across the continuum. You will review medical records, apply InterQual and payer criteria, and collaborate with physicians, nursing staff, and payers to determine appropriate status and level of care.

On-site seven days a week with weekend rotation and occasional holidays, you will drive discharge planning, resource utilization, and timely

Qualifications

• RN license required and active.
• 3–5 years acute care hospital experience preferred.
• Critical Care or Emergency Department experience desirable.
• CCM/ACM certification within two years of hire preferred.

Responsibilities

• Review medical records to ensure appropriate utilization and care delivery.
• Apply InterQual criteria, physician certification, and payer criteria for admission decisions.
• Coordinate discharge planning and transitions across the continuum of care.
• Collaborate with physicians, nursing staff, and payers to determine patient status and level of care.
• Identify barriers to timely discharge and facilitate resources.
• Maintain timely communication with multidisciplinary team and families.

Skills

Negotiation

Communication

Interdisciplinary collaboration

Management

Creative problem solving

Critical thinking

Time management

Multitasking

Education

RN - Registered Nurse

BSN preferred

Tools

InterQual

EHR

Epic

Job description

South Shore Health seeks an experienced RN Case Manager to advocate for SSH&EC clients, coordinate services, and ensure quality, cost-efficient care across the continuum. You will review medical records, apply InterQual and payer criteria, and collaborate with physicians, nursing staff, and payers to determine appropriate status and level of care.

On-site seven days a week with weekend rotation and occasional holidays, you will drive discharge planning, resource utilization, and timely