RN Case Manager - Discharge & Care Coordination Lead

South Shore Health; Hanover (MA); On-site; USD 85,000 - 105,000; Full time

Job summary

South Shore Health is seeking an RN Case Manager to coordinate and advocate for SSH&EC clients. You will assess medical necessity, perform discharge planning, and collaborate with physicians, nurses, and payers to ensure high-quality, cost-effective care.

The role requires on-site availability seven days a week, with weekend rotations and occasional holidays. You will review records using InterQual criteria, assist in status determinations, and support transitions across the continuum of care,

Qualifications

• Active RN license; 3–5 years acute care hospital experience preferred.
• Strong negotiation, communication, and critical thinking skills.
• Familiarity with InterQual criteria and utilization management.
• Experience with EHR systems (Epic) and discharge planning.

Responsibilities

• Review medical records to determine medical necessity using InterQual and payer criteria.
• Coordinate discharge planning and care transitions to optimize outcomes.
• Identify and resolve barriers to timely discharge and resource utilization.
• Collaborate with physicians, nurses, social workers, and payers for placement and follow-up care.
• Document care plans and communicate recommendations to the care team.

Skills

Case management

InterQual

Discharge planning

Communication

EHR/EPIC

Education

Bachelor of Science in Nursing

Tools

InterQual

Epic EHR

Job description

South Shore Health is seeking an RN Case Manager to coordinate and advocate for SSH&EC clients. You will assess medical necessity, perform discharge planning, and collaborate with physicians, nurses, and payers to ensure high-quality, cost-effective care.

The role requires on-site availability seven days a week, with weekend rotations and occasional holidays. You will review records using InterQual criteria, assist in status determinations, and support transitions across the continuum of care,