RN Case Manager: Expert Care Coordination & Discharge

South Shore Health; Holbrook (MA); On-site; USD 75,000 - 110,000; Full time

Job summary

South Shore Health in Massachusetts is seeking an experienced RN Case Manager to coordinate, review and optimize patient care across observation and inpatient stays. The role emphasizes clinical judgment, discharge planning and resource utilization to ensure quality outcomes and cost-effective care.

You will use InterQual criteria, collaborate with physicians and the interdisciplinary team, and manage complex cases seven days a week with rotating weekends and holidays.

Qualifications

• Minimum Education - Registered Nurse; Bachelor’s degree preferred.

Responsibilities

• Reviews medical records for observation and inpatient admissions to ensure appropriate utilization and care.
• Coordinates discharge planning and care coordination across the continuum of care.
• Collaborates with physicians, nursing staff and payors to determine medical necessity and appropriate level of care.
• Assists in preventing delayed discharges and facilitates timely transitions through the SSH&EC system.
• Uses InterQual criteria and payer requirements to support decisions regarding admission and continued stay.

Skills

Negotiation

Communication

Conflict resolution

Interdisciplinary collaboration

Management

Creative problem solving

Critical thinking

Time management

Multitasking

Verbal communication

Written communication

Education

Registered Nurse

Bachelor's degree

Tools

InterQual

Epic

Workday

Job description

South Shore Health in Massachusetts is seeking an experienced RN Case Manager to coordinate, review and optimize patient care across observation and inpatient stays. The role emphasizes clinical judgment, discharge planning and resource utilization to ensure quality outcomes and cost-effective care.

You will use InterQual criteria, collaborate with physicians and the interdisciplinary team, and manage complex cases seven days a week with rotating weekends and holidays.