Nurse Case Manager

Sturdy Memorial Hospital•Attleboro, MA

4d•$87,015 - $135,324

About The Position

The RN Case Manager works in collaboration with patients, families or legal representatives, social workers, physicians, and the interdisciplinary team. The role is accountable for assessing, coordinating, and facilitating patient progression through the continuum of care in an efficient and cost-effective manner. This includes early assessment of pre-admission level of care and post-hospital discharge needs, reviewing available resources, and communicating in a timely and focused manner with the healthcare team and patient or representative. This position is scheduled for 24 hours per week, working every weekend from 8:00 a.m. to 4:30 p.m., with a floating day during the week. It is sign-on bonus eligible. The listed salary range is $87,015.12–$135,323.52; the posting notes that annual salary figures are based on full-time employment and that actual compensation depends on factors such as work history, experience, skills, and education.

Requirements

Minimum 3–5 years of acute-care case-management experience, with demonstrated utilization-review skills.
Demonstrated critical-thinking and problem-solving skills to facilitate safe, timely patient transitions of care.
Excellent communication skills and positive interpersonal skills when working with varied stakeholders across the care continuum.
Solid knowledge of insurance-plan regulations, including CMS and Medicaid requirements, to ensure compliance with processes and documentation.
Ability to gather and use information effectively to develop and modify patient plans of care.
Strong analytical ability to interpret patient-related information, evaluate continued-stay appropriateness and ancillary-service needs, and reassess discharge planning based on daily assessment.
Ability to use industry-accepted utilization or medical-management criteria in patient-status decisions.
Ability to work independently as a self-starter within the scope of the position and licensure, department policies, and established goals.
Excellent computer skills for accurate documentation supporting patient status and medical necessity.
Graduate of an accredited school of nursing; RN required.
Associate of Science in Nursing (ASN) required.
Current Massachusetts RN license required.
Ability to communicate effectively with all age levels served within the scope of the position and assigned areas.
Ability to perform essential job functions without posing a direct threat to workplace health and safety, with or without reasonable accommodation.

Nice To Haves

Bachelor of Science in Nursing (BSN) or Master of Science in Nursing (MSN).
Experience with Meditech and Cerner.
Denials-management experience.
Certified Case Manager (CCM).
Accredited Case Manager (ACMA).

Responsibilities

Assess, coordinate, and facilitate patient progression through the continuum of care in an efficient, cost-effective manner.
Assess pre-admission level of care and post-hospital discharge needs early in the care process.
Review available resources and communicate timely, focused information to the healthcare team and patient, family, or legal representative.
Use critical thinking and problem-solving to facilitate safe and timely transitions of care.
Interpret patient-related information, evaluate continued-stay appropriateness and the need for ancillary services, and reassess discharge-planning needs based on daily assessments.
Use accepted utilization or medical-management criteria to support patient-status decisions.
Document information supporting patient status and medical necessity in the electronic health record.
Coordinate services, advocate for patients, and communicate with stakeholders across the care continuum.
Attend and participate professionally in meetings with hospital leaders, physicians, patients, and families.