RN Case Manager - Utilization & Discharge Lead

STI; Cambridge (MA); On-site; USD 90,000 - 115,000; Full time

Job summary

Beth Israel Deaconess Medical Center in Cambridge, MA is seeking a Case Manager - Registered Nurse to support inpatient utilization review, discharge planning, and care coordination. This 40-hour week role requires active MA RN license and Epic experience, with local candidates only.

The position involves a 3-6 month contract, day shifts, and weekend rotation as needed. Candidates must meet regulatory requirements and collaborate with physicians and care teams to optimize patient outcomes.

Qualifications

• Bachelor's degree preferred; current state license as a Registered Nurse.
• Three years of medical/surgical nursing care experience; two years in case management or utilization management.
• Basic computer and typing skills.
• Effective verbal communication skills and problem solving and conflict resolution skills.
• Demonstrated ability to organize and work independently.

Responsibilities

• Performs utilization review and discharge planning for inpatient admissions.
• Applies InterQual Inpatient criteria approved by MACIPA.
• Communicates with attending and house staff regarding inpatient options.
• Uses clinical expertise to determine appropriate level of care.
• Coordinates discharge with MAH nursing and social work staff.
• Identifies days not meeting acute hospital level of care criteria.
• Works with patients and families to plan post-hospital care.
• Manages observation status patients with physicians.
• Participates in Saturday, holiday and beeper rotation.
• Adheres to insurance, contractual, and regulatory requirements.
• Follows MACIPA Case Management standards.

Skills

Verbal communication

Problem solving

Conflict resolution

Organizational skills

Typing

Basic computer skills

Education

Bachelor's degree

Job description

Beth Israel Deaconess Medical Center in Cambridge, MA is seeking a Case Manager - Registered Nurse to support inpatient utilization review, discharge planning, and care coordination. This 40-hour week role requires active MA RN license and Epic experience, with local candidates only.

The position involves a 3-6 month contract, day shifts, and weekend rotation as needed. Candidates must meet regulatory requirements and collaborate with physicians and care teams to optimize patient outcomes.