Point of Entry ER RN Case Manager - Milford Regional, 24 hours Evenings

About the role

In collaboration with other members of the healthcare team, the Point of Entry/Emergency Department Case Manager is accountable for coordination and facilitation of the management of care for ED patients, both inpatient and observation. The POE/ED CM manages patient flow through the ED by evaluating incoming patients and assisting in determining appropriate discharge disposition (Home, Post-acute Services, Inpatient, or Observation). This includes early assessment of discharge needs and communication among healthcare team members and family/caregivers. The POE/ED CM collaborates with admitting teams to ensure correct initial admission status using InterQual criteria.

Responsibilities

• Patient Identification and Communication: Reviews all ED patients promptly; reviews all admitted patients within one hour of admission or before admitting orders are placed; intervenes early for patients with progressive conditions or complex needs; ensures communication among MSW, CM, and ED care team.
• Assessment and Documentation: Completes and documents initial discharge planning assessments; refers complex or high-utilizer patients for MSW psychosocial assessment; identifies and documents readmissions for follow-up.
• Utilization Review: Completes admission reviews using InterQual criteria; collaborates with providers to resolve discrepancies in medical necessity; documents clinical reviews in Meditech per standards.
• Discharge and Transition Planning: Executes discharge plans in collaboration with ED and admitting physicians; prioritizes discharges requiring post-acute care arrangements; arranges services such as Home Health, DME, SNF, rehab, and medications.
• Escalation and Issue Resolution: Escalates unresolved cases to appropriate leadership; follows formal escalation processes for utilization and level of care issues; documents avoidable delays for boarded ED patients daily.
• Age-Specific Competency: Applies knowledge of growth and development stages to patient care; demonstrates age-appropriate communication and support.

Qualifications

• Bachelor of Science in Nursing
• Current Massachusetts RN license
• Minimum 3 years of medical, surgical, ICU, or ED nursing experience
• Demonstrated sound judgment and knowledge of medical care and support services
• Excellent interpersonal and communication skills
• Analytical ability to evaluate patient care needs and service appropriateness

Preferred qualifications

• CCM certification
• 3–5 years of hospital-based case management experience
• Emergency department experience
• Utilization review experience

Schedule

Monday through Friday, 8:00am – 8:30pm, 24 hours per week. Weekends – every third weekend; holidays – every third holiday. Evening shift, 12.5 hours.

Pay

$84,011.20 – $176,987.20 (final offer may vary based on experience, skills, qualifications, and internal equity considerations).