RN, Care Coordinator, 40hr, Days

Major Responsibilities

• Performs assessment of patient’s physical, functional, and psycho-social needs.
• Identifies complex patients in need of intensive case management.
• Performs admission and concurrent reviews as assigned.
• Performs inpatient reviews in accordance with payer requirements.
• Meets with 3rd party case managers to discuss cases.
• Collaboratively facilitates the care of patients throughout the continuum of care.
• Works as a team member to support /collaborate with Care Coordination Team.
• Works with patients and families to establish objectives, goals and an action plan.
• Educates practitioners on the level of care and documentation requirements.
• Collaborates with the physicians, other care providers and community resources in the care planning process.
• Contacts third party payer to clarify benefit eligibility, coverage, and available resources.
• Negotiates conversion of benefits for previously non-covered services.
• Researches alternate sources of funding for non reimbursed services.
• Coordinates, implements, monitors and evaluates outcomes of the discharge plan.
• Evaluates progress of this plan with the discharge planner, patient, family and the patient’s health care insurer.
• Continually evaluates the patient’s level of care.
• Edits the patient, family and care team regarding resource options, facilitates decision making, initiates plans, and secures resources.
• Supports departmental and medical center-wide performance improvement programs.
• Fosters compliance with regulatory requirements, good practice, and patient care.

Position Qualifications

• Licenses/Certifications/Education: Massachusetts licensure as a registered nurse.
• Experience/Skills: Three (3) years clinical experience in discharge planning or case management. Ability to effectively use specialized computer-based systems for the gathering, reporting, and analysis of clinical data. Excellent organizational and communications skills.

Department-Specific Competencies

• Complies with established departmental policies, procedures and objectives.
• Attends variety of meetings, conferences, seminars as required or directed.
• Demonstrates use of Quality Improvement in daily operations.
• Complies with all health and safety regulations and requirements.
• Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.
• Maintains, regular, reliable, and predictable attendance.
• Participates in other similar and related duties as required or directed.

Qualifications

• License/Certification/Education: Massachusetts licensure as a registered nurse.
• Experience/Skills: Three (3) years clinical experience in discharge planning or case management. Ability to effectively use specialized computer-based systems for the gathering, reporting, and analysis of clinical data. Excellent organizational and communications skills.
• Preferred: Utilization management and third-party payer knowledge.

Benefits

Final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations.

Pay

$86,964.80 - $156,520.00

Schedule

Holidays - Every Other Holiday, Monday through Friday, Weekends - Every Third Weekend Scheduled Hours Varies Business Day Shift 1 - Day Shift, 8 Hours (United States of America) Hours 40