RN, Hospital Case Manager

Baystate Health • Springfield, MA

6d • Onsite

About The Position

Baystate Health is seeking Hospital RN Case Managers to join their growing healthcare teams. There are multiple openings in various locations and specialties, including Full Time Inpatient Unit and Emergency Department roles. The Hospital Case Manager is a registered nurse responsible for coordinating clinical care, quality, and financial outcomes for a designated patient population. This role involves overseeing an efficient plan to ensure continuity and effective community or post-acute reentry, and leading the interdisciplinary team in developing complex discharge plans.

Requirements

• Current Massachusetts Registered Nurse (RN) license
• Associates Degree in Nursing (Required)
• 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 in order to meet deadlines
• Excellent computer skills

Nice To Haves

• BSN preferred
• 3-5 years clinical Nursing experience
• Hospital Case Management, Care Coordination experience strongly preferred
• Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third party payers where appropriate
• Bachelors Degree in Nursing
• Case Management Certification

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

• Medical, dental, and vision coverage, including local Health New England plans.
• Tuition assistance, CEUs, and professional development opportunities.
• Clinical advancement, leadership development, and internal career opportunities.
• Career options across Baystate Health hospitals, practices, and services throughout western Massachusetts.
• Retirement savings and employer match.
• Generous PTO for eligible employees.

What This Job Offers

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