Case Management RN Specialist

3 weeks ago


Boston, Massachusetts, United States Pride Health Full time
Job Overview: Pride Health is seeking a skilled RN Administrator – Case Manager to join our team. As a key member of our healthcare staff, you will be responsible for managing patient caseloads, assessing physical and mental health impairments, and determining medical necessity using InterQual screening and Medicare guidelines. You will also implement strategies to meet patient health needs, reduce length of stay (LOS), and optimize resource use.

About the Role:
  • Collaborate with patients, families, and healthcare teams to ensure cost-effective, high-quality outcomes.
  • Evaluate admission appropriateness and benefits/plan eligibility issues.
  • Develop and implement individualized care plans that meet patient health needs.
  • Maintain accurate and detailed records of patient interactions and care plans.

Requirements:
  • Bachelor's degree in Nursing required.
  • At least 3 years of experience in acute inpatient care and case management.
  • Knowledge of current MS patterns of practice, treatment expectations, and eligibility criteria.

We offer a dynamic work environment, opportunities for professional growth and development, and a competitive salary and benefits package. Estimated salary: $90,000 - $125,000 per year.

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