Pride Health is hiring: RN - Case Manager in Boston

Job Title: RN – Case Manager
Shift: Days, 4x10-Hour Shifts (7:00 AM - 5:30 PM)
Guaranteed Hours: 40 Hours/Week
Location:  Boston, MA 02118
Contract: 13 weeks with the possibility of extension.
Availability: No major holidays, every 6th weekend

Position Overview

We are seeking a highly skilled RN Administrator – Case Manager with a strong background in acute inpatient care and case management. The role focuses on assessing, planning, implementing, and evaluating care options for patients while ensuring quality outcomes and efficient utilization of resources.

Key Responsibilities

• Patient Caseload: Manage 18-22 patients utilizing a collaborative care process.
• Clinical Oversight: Assess physical and mental health impairments, and determine medical necessity using InterQual screening and Medicare guidelines.
• Care Management: Implement strategies to meet patient health needs, reduce length of stay (LOS), and optimize resource use.
• Communication: Coordinate with patients, families, and the healthcare team to ensure cost-effective, high-quality outcomes.
• Utilization Review: Evaluate admission appropriateness and benefits/plan eligibility issues.

Required Qualifications

• Education: BSN required.
• Experience:
  • Minimum 3 years in acute inpatient care and case management.
  • Knowledge of current MS patterns of practice, treatment expectations, and eligibility criteria.
• Certifications:
  • Preferred: CCM (Certified Case Manager) or related certification.
• Technical Skills:
  • Proficiency with EPIC electronic medical record systems.