Registered Nurse, Care Management

Boston Medical Center • Boston, MA

72d

About The Position

At Boston Medical Center (BMC), our nurses are changing the face of healthcare. At every level and on every unit, BMC nurses are advancing professional practice and delivering evidence-based care to our patients, families, and community. Join our Magnet recognized organization as a registered nurse (RN) and help us continue to carry out our mission of delivering exceptional and equitable care to all As both the largest trauma hospital and largest safety net hospital in New England, you get a chance to be a part of exciting leading edge clinical care, in a truly mission driven organization. As one of the top places to work in health care, we know that providing exceptional care for patients begins with caring for our staff. That's why you'll find a supportive work environment at BMC, with rich opportunities throughout your career for training, development, and growth and where you'll have the tools you need to take charge of your own practice environment. There's never been a better or more exciting time to become a BMC nurse. Utilizing a collaborative process, the care manager will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual's health needs, using communication and available resources to promote quality, cost-effective outcomes. The care manager helps identify appropriate providers and facilities throughout the continuum of services while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the patient and the reimbursement source. This care manager is dedicated to handle the increased volume and to support the overall care management process and the department.

Requirements

• Graduate of an accredited ASN/BSN Program in Nursing. Ability to receive BSN within 4 years of hire date.
• Licensed to practice as a Registered Nurse in the commonwealth of Massachusetts
• 3-5 years of diversified clinical experience is required
• A minimum of 2 years of previous experience involving judgment and decision making, preferably in a utilization management/case management position
• Extensive background and knowledge of current medical/surgical patterns of practice.
• Medical terminology and standard medical abbreviations.
• Managed care concepts, the various health care delivery systems
• Methods for assessing an individual are level of physical/mental impairment, understanding of the physical and psychological characteristics of illness, and understanding of expected treatment.
• Confidentiality issues and the legal and ethical issues pertaining to them.
• ICD-9 and CPT nomenclature and the ability to interpret and convert this information, as applicable.
• Knowledge of benefits and various plan contracts, eligibility issues and requirements.
• Role and functional responsibilities of case management professional; case management program philosophy and purpose within Managed Care Program
• Excellent interpersonal, verbal and written communication and negotiations skills
• Strong analytical, data management and PC skills

Nice To Haves

• CCM or related certification attained within 24 months from the hire date is preferred

Responsibilities

• assess, plan, implement, monitor, and evaluate the options and services required to meet an individual's health needs
• using communication and available resources to promote quality, cost-effective outcomes
• identify appropriate providers and facilities throughout the continuum of services
• ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the patient and the reimbursement source

What This Job Offers

• Career Level: Mid Level
• Industry: Hospitals
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees