RN Case Manager

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