Job Title: RN Case Manager – Emergency Department
Location: Hyannis, MA
Duration: 13 Weeks
Hours per Week: 37.5
Schedule: 11:00 PM – 7:00 AM | Every Other Weekend and Holiday Required
Pay Rate: $56–$66/hour
We are seeking a skilled and compassionate RN Case Manager to join the Emergency Department team at a leading healthcare facility in Hyannis, MA. The RN Case Manager will play a critical role in coordinating patient care to ensure high-quality, cost-effective outcomes. This position requires strong collaboration with the interdisciplinary team, expertise in discharge planning, and an understanding of payer guidelines and utilization review standards.
Conduct daily screenings of new admissions for discharge planning needs
Prioritize cases based on screening outcomes and verify demographic and payer information
Apply InterQual® criteria to assess admission status (Inpatient/Observation)
Initiate and manage HINN notices and patient appeal rights
Collaborate with healthcare providers to develop and coordinate individualized care plans
Advocate for patients and families regarding care decisions and insurance coverage
Facilitate communication with third-party payers to secure reimbursement
Refer patients to appropriate community resources for post-discharge care
Monitor length of stay and collaborate with Physician Advisor as needed
Coordinate safe and timely patient transfers to other facilities or services
Ensure thorough and timely discharge and referral documentation
Maintain up-to-date knowledge of regulatory and payer guidelines
Deliver professional and compassionate service aligned with organizational values
Minimum of 3 years of acute care experience in a hospital or case management setting
Recent experience in Discharge Planning and Utilization Review (within the last 4 years)
Active RN license in Massachusetts
Bachelor’s Degree in Nursing preferred
Case Management Certification (CCM, CPUM, or related) preferred
Excellent communication, organizational, and negotiation skills