Job Title: RN Case Manager
Location: Hyannis, MA 02601
Duration: 12 Weeks
Schedule: Monday to Friday, 11:30 AM – 10:00 PM
Rotation: Every Other Weekend & Every Other Holiday
Pay Rate: $65 – $68 per hour
Required: Active RN license and BLS
Conduct daily screenings of new admissions for discharge planning needs.
Complete initial assessments within one business day and reassess every three days or as needed.
Use InterQual® criteria to evaluate appropriateness of admission and level of care; initiate necessary notices.
Facilitate third-party payer communications and ensure timely response to clinical information requests.
Coordinate and document safe discharge plans, ensuring coverage and continuity of care.
Act as a patient advocate in navigating coverage issues and care options.
Collaborate in daily unit rounds and interdisciplinary team meetings.
Identify patients with complex needs and refer to appropriate support services.
Support accurate documentation for reimbursement and regulatory compliance.
Maintain core competencies and up-to-date knowledge of case management best practices.
Active Massachusetts RN license
Current BLS certification
Minimum 3 years recent acute care hospital experience (within the past 5 years)
Experience with InterQual® or equivalent system
Recent discharge planning and utilization review experience (within the past 4 years)
Strong communication, organizational, and time-management skills
Ability to work independently in a fast-paced, dynamic environment
Proficiency with computers and electronic documentation systems
Bachelor of Science in Nursing (BSN)
Certification in Case Management (CCM) or CPUM