RN Case Manager - RN25-26890

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