Point of Entry RN/ER Case Manager - Per Diem
About The Position
At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. In collaboration with other members of the healthcare team, 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
- 3–5 years of hospital-based case management
- Emergency department experience
- Utilization review experience
- CCM certification
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.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Part-time
Career Level
Entry Level
Number of Employees
5,001-10,000 employees
