RN Hospital Case Manager

Baystate Health • Springfield, MA

7d • 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.

Requirements

• BSN Required
• 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
• Associates Degree in Nursing (Required)
• Bachelors Degree in Nursing
• Case Management Certification - Other
• Registered Nurse - State of Massachusetts

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.
• Su 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
• Reimbursement for a variety of well-being activities, included but limited to gym membership and equipment, personal trainer, massage and so much more!
• Wellbeing programs that include but are not limited to mental, physical, and financial health

What This Job Offers

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