Nurse Manager, Complex Case Management,

About the Role

As a member of the Case Management leadership team, the Nurse Manager for Complex Case Management and the ED manages complex patient concerns elevated by frontline case managers. This individual identifies trends with complex patients using databases, observations of workflows, and communications with intradisciplinary teams. They consolidate information, present it to hospital leadership, and work closely with key stakeholders to reduce barriers to discharge, length of stay, and increase key BMC performance measures for all complex inpatient discharges, including patients experiencing homelessness and within the conservator/guardianship process.

Responsibilities

• Performs management duties in collaboration with the nurse director to achieve and maintain quality services and positive employee relations.
• Supervises (hires, evaluates, and disciplines) all RN and non-RN staff according to established personnel policies, procedures, and union contracts.
• Initiates and facilitates problem-solving by timely identification and communication of staff and patient care issues and solutions to the nurse director.
• Assures that staff schedules are completed and posted in accordance with nursing department policies, procedures, and union contract requirements.
• Acquires, maintains, and utilizes knowledge of current labor contracts and personnel policies and procedures, initiates timely and appropriate management interventions, inclusive of coaching, counseling, and progressive discipline.
• Conducts independent investigations of employee incidents involving clinical practice issues, including review of employee personnel files, discipline records, and evaluations.
• Promotes and facilitates staff’s professional development to ensure the unit provides quality nursing care.
• Participates in quality improvement activities and on committees to ensure that Standards of Care/Practice are evaluated and met.
• Coordinates clinical activities to ensure safe and efficient functioning of the unit based on patient needs.
• Works collaboratively with intradisciplinary teams on key task forces to reduce barriers for complex patients and improve BMC metrics.
• Serves as a subject matter expert to staff responsible for executing complex care management functions.
• Interfaces with and educates physicians and other stakeholders regarding the goals and objectives of care management and roles/responsibilities of staff.
• Analyzes and evaluates the effect of care management on quality outcomes, fiscal parameters, customer satisfaction, and system operations.
• Conducts clinical performance improvement audits and provides timely feedback to personnel.
• Maintains detailed criteria for inclusion and exclusion in the complex case management caseload.
• Facilitates interdisciplinary consultation on patient’s behalf through participation in rounds, family meetings, team meetings, and clinical reviews.
• Analyzes issues and trends in bed management and utilization of resources and strategizes to address them.
• Assists in the collection and reporting of financial indicators including case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials, and appeals.

Qualifications

• Graduate of an accredited baccalaureate nursing program (BSN) required by start date.
• Master’s Degree in Nursing or a health-care related field preferred.
• Licensed to practice as a Registered Nurse in the Commonwealth of Massachusetts by start date.
• CCM or related certification attained within 24 months from the hire date is preferred.

Experience

• Minimum of 3-5 years of inpatient clinical nursing experience.
• Minimum of 2 years of case management experience.
• Preferred: ACM-RN or CCM, experience working with vulnerable patient populations, ED experience, ED Case Management Experience, clinical experience working with patients with multiple complex health issues, progressive leadership experience.

Skills

• Analytical abilities required to organize, supervise, and evaluate the work of others.
• Strong interpersonal skills with the ability to guide, direct, mentor, train, and work collaboratively in a team-building environment.
• Effective English communication skills (oral and written).
• Bilingual or multi-lingual skills (beyond English) appropriate to the patient population served is a plus.
• Basic computer proficiency inclusive of ability to access, enter, and interpret computerized data/information.
• Excellent interpersonal, verbal, and written communication and negotiation skills.
• Strong organizational and time management skills.

Pay

$122,000.00 - $177,000.00. This range offers an estimate based on the minimum job qualifications. Our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market competitiveness.