RN Case Manager - Float - MGH

Mass General Brigham • Boston, MA

1d • $42 - $108 • Onsite

About The Position

As Registered Nurses (RNs) at Massachusetts General Hospital, our every action is guided by knowledge, enabled by skill, and motivated by compassion. Patients are our primary focus, and the way we deliver care reflects that focus every day. We believe in creating a healing environment — an environment that is safe, has no barriers, and is built on a spirit of inquiry—an environment that reflects a diverse, inclusive, and culturally competent workforce representative of the patient-focused values of this institution. The Case Manager, as a member of the health care team, collaborates to enhance the delivery of patient care services along the continuum of care. The Case Manager meets patient’s needs efficiently and expeditiously by continuously improving the patient’s experience, helping to ensure the institutional standards of high-quality patient care, reducing cost, and ensuring reimbursement. Through broad knowledge of clinical care and systems management, the case manager evaluates, predicts, and facilitates the trajectory of patient care. The case manager employs a collaborative process of assessment, planning, implementation, care coordination, monitoring, advocacy, and evaluation to meet the individual’s health care needs. We currently have exciting opportunities for RNs to work in the Case Management department. The Case Management Department provides an in-depth orientation and onboarding program. We also have an innovative “Novice to Expert” program. MGH has a Clinical Recognition Program which provides a path to formally recognize clinical staff for their expertise in caring for patients and families. Case Managers are supported by strong leaders, subject matter expert colleagues, and case management resource specialists. We are truly a team!

Requirements

• Associate's Degree Nursing required or Bachelor's Degree Nursing preferred
• MA Registered Nurse License required
• Basic Life Support [BLS Certification] - Data Conversion - Various Issuers preferred
• Case management, utilization review, or discharge planning experience 2-3 years preferred
• Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
• Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
• Ability to establish strong rapport and relationships with patients and staff.
• Proficient in Microsoft Office and industry-related software programs.
• Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
• Ability to maintain client and staff confidentiality.
• Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care.
• Knowledge of Healthcare and Managed Care preferred.

Nice To Haves

• Bachelor's Degree Nursing preferred
• Basic Life Support [BLS Certification] - Data Conversion - Various Issuers preferred
• Knowledge of Healthcare and Managed Care preferred.

Responsibilities

• Serves as a core member of the care team, coordinates and supports healthcare within the facility, and coordinates referrals for services outside the clinic.
• Provides outreach and enrollment services to meet the program's eligibility requirements and those of the surrounding counties.
• Ensures coordination and planning, including community and family support.
• Focuses on the development and coordination of community service plans.
• Partners with service providers, families, and patients to create a plan of healthcare and identify additional service providers.
• Client Assessments and Planning.
• Modify patient treatment plans as indicated by patients' responses and conditions.
• Prepare patient/family for discharge.
• Communicates with third-party payers to obtain necessary authorization for reimbursement of services.
• Review cases with medical directors as needed to discuss challenging cases.
• Defines care goals of patients by providing education, information, and direction to each individual and family.
• Maintain accurate, detailed reports and records.
• Communicates with third-party payers to obtain necessary authorization for reimbursement of services.

Benefits

• Medical, Dental and Vision insurance
• Tuition Reimbursement
• Generous paid time off
• Subsidized MBTA pass (50% discount)
• Resources for childcare and emergency backup care
• Hospital paid retirement plan and tax-sheltered annuity plan
• Employee “Perks” - enjoy discounts on tickets and passes for everything from ski resorts to museums to sporting events.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree