Nurse Manager, Care Management, 40 Hours (Days)

Boston Medical Center•Boston, MA

20h•$122,000 - $177,000

About The Position

Provides direct supervision for the Nurse Care Managers in the Case Management department. Accountable for hiring, scheduling, supervising and completing the performance appraisal process of all nurse case management staff. Oversees the coordination of special projects and programs within the department including; Utilization Review, Care Coordination, Discharge Planning and RN Continuing Education Program. Will also utilize nursing techniques and theory, to consult on, assess, and intervene with high-risk patients and their families regarding the impact/amelioration of medical and physical problems. Position: Nurse Manager Department: Care Management Schedule: 40 Hours (Days)

Requirements

Ability to understand confidentiality and the legal and ethical issues pertaining to patient health; understand medical terminology, how to obtain an accurate history; establish treatment goals; establish working relationships with referral sources; develop treatment plans.
Ability to understand methods for assessing an individual’s level of physical/mental impairment; understand the physical and psychological characteristics of illness; be able to assist individuals with the development of short- and long-term health goals.
Ability to understand the requirements for prior approval by payer; be able to evaluate the quality of necessary medical services; be able to acquire and analyze the cost of care; understand the various health care delivery systems and payer plan contracts; be able to demonstrate cost savings.
Ability to understand case management philosophy and principles; apply problem solving techniques to the care management process; document care management services; understand liability issues for care management activities.
Knowledgeable on how to access and evaluate the available resources to meet a client’s needs; able to develop new resources.
Excellent interpersonal, verbal, and written communication and negotiation skills
Strong analytical, data management and PC skills.
Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.
Understanding of pre-acute and post-acute venues of care and postacute community resources.
Strong organizational and time management skills, as evidenced by a capacity to prioritize multiple tasks and role components.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
Requires BSN from an accredited school of Nursing.
Must be licensed to practice professional nursing as a Registered Nurse in the Commonwealth of Massachusetts.
Minimum of 3-5 years’ clinical experience required and 1-3 years of acute, Inpatient Care Management experience required.

Responsibilities

Provides direct supervision for the Nurse Care Managers in the Case Management department.
Accountable for hiring, scheduling, supervising and completing the performance appraisal process of all nurse case management staff.
Oversees the coordination of special projects and programs within the department including; Utilization Review, Care Coordination, Discharge Planning and RN Continuing Education Program.
Will also utilize nursing techniques and theory, to consult on, assess, and intervene with high-risk patients and their families regarding the impact/amelioration of medical and physical problems.