RN Case Manager 32 hours, Days

Major Responsibilities

• Evaluate appropriateness of inpatient admission and assess patient needs to identify high-risk individuals and initiate referrals.
• Participate in the development and monitoring of interdisciplinary guidelines and variance tracking.
• Work with physicians and healthcare providers to enhance quality of care and utilization management.
• Facilitate timely discharge through early intervention and coordination of services.
• Monitor compliance, collect utilization data, and identify cases for quality and utilization review.

Position Qualifications

• Required: BSN, Current Massachusetts RN license, 3–5 years of clinical experience with sound judgment and knowledge of current medical care and support systems, previous utilization review, quality assurance, or community experience, strong interpersonal and analytical skills.
• PREFERRED: CCM certification, N/A