Registered Nurse (RN) Case Manager

The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge, and prevent avoidable readmissions. This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention, and patient satisfaction; Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards, and Tenet policy; Education provided to physicians, patients, families and caregivers. Responsibilities Accurate medical necessity screening and submission for Physician Advisor review Identifying and referring complex patients to Social Work Services Collaborating with physicians, office staff and ancillary departments Timely complete and concise documentation in Case Management system Identification and documentation of potentially avoidable days, Identification and reporting over and underutilization Performs related duties as required Qualifications Required: Education: Graduate of an accredited school of nursing Experience: 2 years of acute hospital patient care experience Licensure/Certification: RN Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy Active RN license for state(s) covered. Preferred: Education: Academic degree in nursing (bachelor's or master's) Experience: Acute hospital case management experience Licensure/Certification: Accredited Case Manager (ACM) About Us Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the opportunity to make a meaningful impact in patients' lives while enjoying a supportive work environment that fosters professional growth and work-life balance. At Metrowest Medical Center - Consolidated, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include: Medical, dental, vision, and life insurance 401(k) retirement savings plan with employer match Generous paid time off Career development and continuing education opportunities Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance Note : Eligibility for benefits may vary by location and is determined by employment status About the Team MetroWest Medical Center has been serving the community since we opened as the first public medical facility in Framingham in 1893. MetroWest Medical Center is comprised of Framingham Union Hospital and Leonard Morse Hospital, a unique behavioral health specialty center located in Natick dedicated to the mental health of our community. At Framingham Union Hospital, youll find comprehensive health care services for the entire family including 24-hour emergency care, advanced cardiac care, high-tech cancer treatments and advanced maternity care including our Special Care Level IIB nursery and high-risk pregnancy care. MetroWest Medical Center was recognized by the Joint Commission with a Gold Seal of Approval, a symbol of quality that reflects our commitment to meeting performance standards and providing safe and effective patient care. Our skilled cardiac team was recognized as one of Healthgrades Americas 100 best hospitals for Coronary Intervention and ranked among the top 5% in the nation for coronary interventional procedures in 2023. At MetroWest Medical Center, you can grow your career skills and be a vital member of our team dedicated to improving the health of our community. Join us! Job Info Job Identification View phone number on click.appcast.io Job Category Support/Clinical Posting Date 09/01/2026, 03:31 AM Degree Level Associate's Degree/College Diploma (±13 years) Job Schedule Part time Job Shift Day Locations Metrowest Medical Center - Framingham Union Campus (On-site) Pay Range $36.95 - $57.27 **Individual wages are determined based upon a number of factors including, but not limited to, an individual’s qualifications and experience #J-18808-Ljbffr Oracle Corporation