RN Manager, Case Management Quality Talent Group - 5.0 Boston, MA Job Details Full-time $117,707.20 - $170,768.00 a year 20 hours ago Benefits Disability insurance Health insurance Dental insurance 401(k) Flexible spending account Tuition reimbursement Paid time off Employee assistance program Vision insurance 401(k) matching 403(b) Opportunities for advancement Life insurance Pet insurance Qualifications Collaborate with healthcare professionals Managed Registered Nurses (RNs) Registered Nurse (RN) License — Massachusetts Utilization review RN License Finance Health insurance policy knowledge Practicing as a nurse case manager InterQual Utilization management Conflict management Resource utilization in healthcare Data analytics Healthcare reimbursement methods Negotiation in dispute resolution

Full Job Description RN Case Manager Location:

Weymouth, MA Compensation Pay Range:

$117,707.20 - $170,768.00 A 370-bed, not-for-profit healthcare system with 5,400+ colleagues , the organization is one of the largest healthcare employers in the Greater Boston area . It has earned Magnet Recognition for Nursing Excellence , the AMA Joy in Medicine designation for 2025-2026 , and a WorkWell Massachusetts Award for employee wellness. Its clinical network includes partnerships with Dana-Farber/Brigham Cancer Center, Mass General Brigham, and Boston Children's Hospital . What You'll Do Review inpatient and observation cases to determine medical necessity, appropriate level of care, and continued-stay requirements using InterQual and payer-specific criteria Coordinate safe, timely discharge planning and transitions to appropriate post-acute care, including SNF, VNA, and home pharmacy services Collaborate with physicians, nursing, patients, families, insurers, and interdisciplinary teams to resolve barriers and support quality, cost-effective care Coordinate referrals, follow-up services, patient/family preferences, and required documentation throughout the continuum of care Monitor utilization, length of stay, reimbursement, and resource consumption while identifying opportunities to improve efficiency and patient outcomes

Benefits:

Medical and Dental Insurance Vision Plan Paid Time Off (PTO) 403(b) Retirement Savings Plan Tuition Assistance Flexible Spending Accounts (FSA) Life Insurance Short- and Long-Term Disability Insurance Wellness programs , including health screenings and coaching Employee Assistance Program (EAP) Legal services 529 College Savings Plan Supplemental insurance options, including critical illness, accident, whole life, and pet insurance Opportunities to work within a Magnet-recognized healthcare organization Professional development and career advancement opportunities Benefits and eligibility may vary based on position, employment status, and location. Requirements Registered Nurse (RN) license required ACM (Accredited Case Manager) or CCM (Certified Case Manager) certification required within two years of hire Knowledge of healthcare financing, community and organizational resources, patient care processes, and data analysis Knowledge of utilization management and third-party payer requirements Managed care experience preferred Excellent verbal and written communication skills Strong negotiation, conflict management, interdisciplinary collaboration, creative problem-solving, critical thinking, time management, and multitasking skills Ability to adapt to changing priorities and regulations Ability to work effectively in a high-stress environment Current nursing licensure and required continuing education InterQual certification Apply now to make a meaningful impact through patient advocacy, care coordination, and safe transitions across the continuum of care.

Pay:

$117,707.20 - $170,768.00 per year

Benefits:

401(k) 401(k) matching Dental insurance Employee assistance program Health insurance Paid time off Tuition reimbursement Vision insurance Application Question(s): Do you consent to Quality Talent Group collecting your application information and submitting it on your behalf for this role at South Shore Health? Your data will be handled securely and used only for recruitment purposes. You may request access to or deletion of your data at any time by contacting us at

Options:

(1) Yes, I consent (2) No, I do not consent Could you please provide your alternative email address? What is the minimum salary you are seeking? When will you be available to begin work? Please describe your desired work schedule and position type, including preferred shift (Day, Evening, Night, or Varied) and employment type (Full Time, Part Time, or Per Diem). If hired by South Shore Health, can you provide documentation verifying your legal authorization to work in the United States? Do you now or will you in the future require sponsorship for an employment visa status? If you are relocating, please provide your future address, city, and state, if known. Are there any current or past restrictions or disciplinary actions on your professional license in any jurisdiction? If yes, please provide details. How would you describe your ethnicity? How do you identify your gender? How do you identify your veteran status?

Work Location:

On the road