RN Case Manager

Baystate Health • Greenfield, MA

1d • Onsite

About The Position

The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that will ensure continuity and effective community or post-acute reentry. The Hospital Case Manager leads the interdisciplinary team in developing complex discharge plans. This position is located at Baystate Franklin Medical Center. Why Choose Baystate Franklin Medical Center? As an 89-bed, nonprofit community hospital, we are a self-sufficient leader in patient care for Franklin County and surrounding areas. Baystate Franklin Community Hospital provides a welcoming environment that prioritizes teamwork and professional development. We are committed to supporting our staff through continuous training and development, fostering a fulfilling and rewarding career. Our strong sense of community, both within the hospital and beyond, allows team members to maintain a healthy work-life balance while making a meaningful impact on the lives of our patients every day

Requirements

• BSN Preferred
• 3-5 years clinical Nursing experience
• Hospital Case Management, Care Coordination experience strongly preferred
• Requires a working knowledge of community resources and Utilization/Quality Review standards and activities conducted by third party payers
• Ability to organize and prioritize workload to meet deadlines
• Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third-party payers where appropriate
• Excellent computer skills
• Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third-party payers where appropriate

Responsibilities

• Facilitates patients care plan as called for in the plan of care
• Leads daily patient care huddles with nursing to direct timely progress along the continuum
• Works cooperatively as a leading member of the health care team to insure appropriate use of hospital resources, patient satisfaction, and achievement of quality of care.
• Manages input from all health care professionals and conducts assessments to determine patients health care and transitional needs.
• Evaluates and ensures appropriateness of admissions and continued stay using evidence-based criteria
• Collaborates and manages outcomes with the payers through ongoing written and verbal communications to appropriate parties
• Leads discussions with Physician advisors and MD's about safe plan for transitions
• Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate
• Collaborates with community case managers and other health care advisors to ensure a smooth and safe continuum of care plan
• Conducts extensive assessments and implements interventions for patients at risk for readmissions
• Manages concurrent denials and works with physicians to overturn for appropriate reimbursement

Benefits

• High-quality, low-cost medical, dental and vision insurance
• Pet, home, auto and personal insurance
• Certification and continuing education reimbursement
• 403b retirement company match & annual company contribution increase based on years of service
• Life insurance
• Free money coach advice from a certified professional

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level