Case Manager - Registered Nurse
Company: STI
Location: Cambridge
Posted on: April 1, 2026
|
|
|
Job Description:
Case Manager - Registered Nurse Cambridge, MA/ Local candidates
not accepted 3-6 Months Description / Comment Shift: 40 hours per
week Usually M-F 8-4:30 Occasional weekend may be required Epic
experience preferred COVID Vaccines Booster required at time of
submission ( declinations not accepted). BILH cover sheet required
Active MA license required at time of submissions Cannot have
worked perm/travel for any Beth Israel facility within the past 6
months. Primary Responsibilities : 1. Performs utilization review
and discharge planning to inpatient admissions to MAH. 2. Applies
InterQual Inpatient criteria approved by the MACIPA (risk) and MAH
(non-risk) Utilization Management Committees to accurately
determine appropriateness for inpatient and outpatient care. 3.
Communicates with attending and house staff when options to
inpatient care are identified. 4. Utilizes clinical expertise to
determine the appropriate level of care for patients. Leads the
healthcare team in selecting appropriate, safe, hospital or
alternative care options. 5. Works with MAH nursing and social work
staff to coordinate and facilitate patient discharge. 6. Identifies
days not meeting acute hospital level of care criteria and reports
them to the physician reviewer. 7. Works with patients and families
to facilitate post hospital care and develop plans to meet short
and long-term needs. 8. Accurately manages observation status
patients by working with physicians to ensure appropriate
utilization. 9. Is part of the department's Saturday, holiday and
beeper rotation as needed. 10. Adheres to all insurance,
contractual, and regulatory requirements as mandated. 11. Abides by
MACIPA Case Management standards as per the MACIPA CM guidelines.
Required Qualifications: 1. Bachelor's degree preferred. Current
state license as a Registered Nurse 2. Three years of
medical/surgical nursing care experience. Two years of case
management or utilization management experience required. 3. Basic
computer and typing skills. 4. Effective verbal communication
skills and problem solving and conflict resolution skills. 5.
Demonstrated ability to organize and work independently.
Keywords: STI, Cambridge , Case Manager - Registered Nurse, Healthcare , Cambridge, Massachusetts
