Hiring.fm
Marshall Medical

ED Case Manager

Placerville, CA Full time

Department:

Case Management

Shift:

Primarily Days (United States of America)

Employee Type:

Regular

Per Diem Type (if applicable):

Minimum Pay Range:

$67.48 - $84.35


Job Description:

POSITION SUMMARY

The Emergency Department Case Manager RN (ED CM) is responsible for ensuring the appropriate use of medical resources by conducting timely utilization reviews, verifying medical necessity, and facilitating accurate level-of-care determinations. This role supports safe transitions of care, promotes efficient patient flow, and helps prevent avoidable admissions and readmissions. The ED CM works closely with physicians, nurses, social workers, and other healthcare professionals to assess patient needs, coordinate care, and support effective discharge planning and follow-up services—all while maintaining compliance with regulatory and payer requirements.

POSITION QUALIFICATIONS

Education/Licensure/Certification:

  • Registered Nurse (RN) is required.
  • Current state license (RN) is in good standing.
  • Certification in Case Management (CCM or ACM) preferred.
  • Current Basic Life Support (BLS) certification required.

Knowledge/Experience:

  • Minimum of 2 years of clinical experience in acute care or emergency settings required.
  • Minimum of 2 years of experience in case management or utilization review (preferably in the ED or acute care setting) required.
  • Knowledge of InterQual, MCG guidelines, and case management principles is required.
  • Strong knowledge of utilization management, medical necessity criteria, and level-of-care guidelines.
  • Strong knowledge of CMS rules and regulations
  • Strong knowledge of clinical care, discharge planning, and community resources.

Skills:

  • Excellent critical thinking, clinical judgment, and fast-paced decision-making skills.
  • Excellent communication, negotiation, and interpersonal skills.
  • Ability to multitask and prioritize in a high-volume, fast-paced ED environment.
  • Proficiency in electronic health records (EHR) and case management software
  • Comfortable with direct patient interaction and frequent collaboration with multidisciplinary teams.