Job Title: RN Case Manager - Inpatient Care Specialty/Department: Case Management
Facility Location: 330 Mount Auburn Street, Cambridge, MA 02138
Contract Length: 13 Weeks
Shift: Day Shift (7:00 AM - 5:30 PM), occasional weekends may be required
Guaranteed Hours: 40 hours/week
Position Overview:
Mount Auburn Hospital is seeking an experienced and licensed Registered Nurse Case Manager to join its inpatient Case Management team. This full-time role involves both utilization review and discharge planning, helping ensure safe, cost-effective care transitions and compliance with regulatory standards. Key Responsibilities: - Conduct utilization review and manage discharge planning for all inpatient admissions.
- Apply InterQual criteria to evaluate the appropriateness of inpatient versus outpatient care.
- Collaborate with physicians and care teams to identify and coordinate alternative care options.
- Determine appropriate levels of care and lead team discussions for optimal patient outcomes.
- Work closely with nursing and social work staff to coordinate discharge plans.
- Identify and report days not meeting acute hospital level of care to the physician reviewer.
- Guide patients and families through post-acute care planning and long-term care arrangements.
- Manage observation status patients to ensure proper documentation and care utilization.
- Participate in rotating coverage for weekends, holidays, and on-call pager shifts.
- Adhere to all regulatory, contractual, and insurance-related requirements.
Requirements: - Active Massachusetts RN license (Required at time of submission)
- COVID-19 vaccine and booster (Required; no declinations accepted)
- Minimum 3 years of medical/surgical nursing experience
- At least 2 years of experience in case management or utilization management
- Strong verbal communication, organization, and conflict-resolution skills
- Computer proficiency, including basic typing skills
- Bachelor's degree in nursing (Preferred)
Additional Details: - Epic EMR experience preferred
- Local candidates not accepted
- Must not have worked (perm or travel) at any Beth Israel facility in the past 6 months