RN Case Manager

Full Time - 40 Hours

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.

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

Required Work Experience: 

• BSN Required

• 3-5 years clinical Nursing experience

• Hospital Case Management, Care Coordination experience strongly preferred

Skills and Competencies: 

• 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

• 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

• There is a weekend and holiday commitment.

THE ADVANTAGES OF WORKING WITH BAYSTATE!

• Excellent Compensation

• 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 wellbeing 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

Our Compensation Philosophy

We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above considers the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role.