RN Case Manager: Discharge & Care Coordination

South Shore Health System; South Weymouth (MA); On-site; USD 118,000 - 171,000; Full time

Job summary

South Shore Health System is seeking an RN Case Manager to independently coordinate, negotiate, procure services, and manage care for complex patients at SSH Care Progression. The role emphasizes utilization review, discharge planning, and collaboration with physicians and payers to ensure quality, cost-effective outcomes.

The position supports on-site, full-time work with weekend and holiday rotations, requiring strong clinical judgment, documentation, and communication.

Qualifications

• Must be a Registered Nurse and licensed to practice.
• 3–5 years acute care hospital experience preferred.
• Critical care or emergency department experience highly desirable.
• Strong negotiation and communication skills with interdisciplinary teams.
• Knowledge of healthcare financing, payer requirements, and discharge planning.

Responsibilities

• Review medical records to ensure appropriate utilization and medical necessity.
• Coordinate and facilitate discharge planning and transitions of care.
• Communicate with physicians, nursing, admissions, and payors to optimize patient status.
• Provide care coordination and resource management across continuum of care.
• Maintain timely documentation and adherence to regulatory requirements.

Skills

Negotiation

Communication

Conflict resolution

Interdisciplinary collaboration

Management

Critical thinking

Time management

Multitasking

Education

RN - Registered Nurse

BSN preferred

Tools

InterQual

EHR (Epic)

Workday

MCCM

Job description

South Shore Health System is seeking an RN Case Manager to independently coordinate, negotiate, procure services, and manage care for complex patients at SSH Care Progression. The role emphasizes utilization review, discharge planning, and collaboration with physicians and payers to ensure quality, cost-effective outcomes.

The position supports on-site, full-time work with weekend and holiday rotations, requiring strong clinical judgment, documentation, and communication.