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Jobs · Healthcare · Massachusetts

RN Case Manager, 7W, 40 Hours (Days / 4x10 Hour Shifts / Every 6th Weekend)

Boston Medical Center (BMC) · Boston, MA · 3 mo ago
On-siteHealthcare$38.05–$75.33/hrFull-time

Position Summary

Utilizing a collaborative process, the care manager will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual’s health needs, using communication and available resources to promote quality, cost-effective outcomes. The care manager helps identify appropriate providers and facilities throughout the continuum of services while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the patient and the reimbursement source. This care manager is dedicated to handle the increased volume and to support the overall care management process and the department.

About the Role

The care manager will work closely with patients, families, and other healthcare professionals to develop and implement care plans that address their health needs. They will also coordinate care across different settings and ensure that all services provided are aligned with the patient's goals and preferences.

Responsibilities

  • Assess and plan care for patients based on their health needs and preferences
  • Identify appropriate providers and facilities throughout the continuum of services
  • Evaluate and monitor the effectiveness of care plans
  • Communicate with patients, families, and other healthcare professionals to ensure coordinated care
  • Ensure timely and cost-effective use of available resources
  • Support the overall care management process and the department

Requirements

  • Graduate of an accredited ASN/BSN Program in Nursing
  • Licensed to practice as a Registered Nurse in the commonwealth of Massachusetts
  • CCM or related certification attained within 24 months from the hire date is preferred
  • BSN preferred and MA RN license required
  • A minimum of 3-5 years recent clinical experience required
  • A minimum of 1-3 years recent acute inpatient Care Management experience required
  • Strong communication, collaboration, and problem-solving skills
  • Knowledge of utilization review, discharge planning, managed care, and community resources
  • Extensive background and knowledge of current medical/surgical patterns of practice
  • Medical terminology and standard medical abbreviations
  • Managed care concepts, the various health care delivery systems
  • Methods for assessing an individual are level of physical/mental impairment, understanding of the physical and psychological characteristics of illness, and understanding of expected treatment
  • Confidentiality issues and the legal and ethical issues pertaining to them
  • ICD-9 and CPT nomenclature and the ability to interpret and convert this information, as applicable
  • Knowledge of benefits and various plan contracts, eligibility issues and requirements
  • Role and functional responsibilities of case management professional; case management program philosophy and purpose within Managed Care Program
  • Excellent interpersonal, verbal and written communication and negotiations skills
  • Strong analytical, data management and PC skills

Qualifications

  • Education: Graduate of an accredited ASN/BSN Program in Nursing
  • Certificates, Licenses, Registrations: CCIM or related certification attained within 24 months from the hire date is preferred
  • Experience: BSN preferred and MA RN license required, A minimum of 3-5 years recent clinical experience required, A minimum of 1-3 years recent acute inpatient Care Management experience required

Skills

  • Communication, Collaboration, Problem-Solving
  • Utilization Review, Discharge Planning, Managed Care, Community Resources
  • Medical Terminology, Standard Medical Abbreviations
  • Managed Care Concepts, Health Care Delivery Systems
  • Assessment of Physical/Mental Impairment, Understanding of Illness Characteristics, Expected Treatment
  • Confidentiality Issues, Legal and Ethical Issues
  • ICD-9 and CPT Nomenclature, Interpretation and Conversion
  • Benefits, Plan Contracts, Eligibility Issues, Requirements
  • Case Management Professional Role, Case Management Program Philosophy, Managed Care Program Purpose
  • Interpersonal, Verbal, Written Communication, Negotiations
  • Analytical, Data Management, PC Skills

Benefits

This employer offers a comprehensive benefits package including medical, dental, vision, pharmacy, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Pay

$38.05 - $75.33 per hour

Schedule

40 Hours (Days / 4x10 Hour Shifts / Every 6th Weekend)

Equal Opportunity Employer

Equal Opportunity Employer/Disabled/Veterans

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