Point of Entry/Emergency Department Case Manager, Per Diem

UMass Memorial Health • Milford, MA

111d

About The Position

The Point of Entry/Emergency Department Case Manager (POE/ED CM) is accountable for coordination and facilitation of the management of care for ED patients, both inpatient and observation. The POE/ED CM manages patient flow through the ED by evaluating incoming patients and assisting in determining appropriate discharge disposition (Home, Post-acute Services, Inpatient, or Observation). This includes early assessment of discharge needs and communication among healthcare team members and family/caregivers. The POE/ED CM collaborates with admitting teams to ensure correct initial admission status using InterQual criteria.

Requirements

• Bachelor of Science in Nursing
• Current Massachusetts RN license
• Minimum 3 years of medical, surgical, ICU, or ED nursing experience
• Demonstrated sound judgment and knowledge of medical care and support services
• Excellent interpersonal and communication skills
• Analytical ability to evaluate patient care needs and service appropriateness

Nice To Haves

• CCM certification
• 3–5 years of hospital-based case management
• Emergency department experience
• Utilization review experience

Responsibilities

• Reviews all ED patients promptly.
• Reviews all admitted patients within one hour of admission or before admitting orders are placed.
• Intervenes early for patients with progressive conditions or complex needs.
• Ensures communication among MSW, CM, and ED care team.
• Completes and documents initial discharge planning assessments.
• Refers complex or high-utilizer patients for MSW psychosocial assessment.
• Identifies and documents readmissions for follow-up.
• Completes admission reviews using InterQual criteria.
• Collaborates with providers to resolve discrepancies in medical necessity.
• Documents clinical reviews in Meditech per standards.
• Executes discharge plans in collaboration with ED and admitting physicians.
• Prioritizes discharges requiring post-acute care arrangements.
• Arranges services such as Home Health, DME, SNF, rehab, and medications.
• Escalates unresolved cases to appropriate leadership.
• Follows formal escalation processes for utilization and level of care issues.
• Documents avoidable delays for boarded ED patients daily.
• Applies knowledge of growth and development stages to patient care.
• Demonstrates age-appropriate communication and support.

Benefits

• Signing bonus available
• Diversity and inclusion initiatives
• Support for career development

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees