RN Case Manager

POSITION SUMMARY Position: RN Case Manager Location: BMC South - Brockton, MA Schedule: Part Time, 32 hours, Every 3rd Weekend. The RN Case Manager (CM) is an exempt position and is responsible for overseeing the appropriate level of care and collaborates with the Social Work partner regarding discharge planning with a particular focus on medically complex discharge planning. The RN CM will be assigned to selected areas of the Hospital based upon department staffing and coverage. The RN CM will collaborate with SW Care Coordinator as a team to meet the needs of the patients within unit assigned. As this is an evolving position, duties and responsibilities may vary based on specific assignments. Each staff member will participate in a departmental orientation focused on Case Management Standards of Practice. All staff will be cross-trained and oriented to the ED Case Management Practice. ESSENTIAL RESPONSIBILITIES / DUTIES Scope of Authority: Perform InterQual reviews on assigned patients and working with insurers to provide clinical information, answer questions, obtain insurance authorization for patients. Collaborate with Social Worker (SW) Care Coordinators on the units who will be responsible for the development and execution of patient discharge plans. Coordinate with the SW Care Coordinators for clinically difficult discharge plans. Review reports on the Department's performance including but not limited to LOS, clinical denials and appeal status, avoidable days, time of discharge, proper level of documentation. Work with Care Coordination Manager/Director to develop educational needs and identify strategies to accomplish objectives of the Department. JOB REQUIREMENTS Education: Nursing degree required: diploma, ASN or BSN (preferred); Ability to obtain BSN within 4 years required. Certifications/Licenses: MA RN licensure, Case Management certification preferred. Experience: Recent experience in acute care setting involved with clinical activities and/or a managed care environment working in case management, recent experience in a case management role or related role. Knowledge & Skills: Excellent computer skills including managing work against performance metrics and reporting on key indicators important to the department. Strong computer skills with knowledge and proficiency with Microsoft Word, Excel and PowerPoint. Demonstrate data analytic skills. Demonstrated skills in working collaboratively with physicians, managers and other team members. Demonstrated skills in organizing and facilitating interdisciplinary teams to ensure timely discharge. Compensation and Benefits Compensation Range: $38.86- $80.77. This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing. Equal Opportunity Employer / Disabled / Veterans Boston Medical Center is an equal employment/affirmative action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic. If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail to View email address on click.appcast.io or call View phone number on click.appcast.io to let us know the nature of your request. BMC requires all staff to be vaccinated against COVID-19 and flu, as well as receive a booster dose of the COVID-19 vaccine. Boston Medical Center participates in the Electronic Employment Verification Program. As an E-Verify employer, prospective employees of BMC must complete a background check before beginning their employment at the hospital. BMC's mission to provide exceptional care without exception extends to our employees, and we have been recognized as a top employer and best place to work. A strong sense of teamwork and support for our staff are the bedrock of BMC, as we know that we can only provide exceptional care to patients when our staff are cared for too. #J-18808-Ljbffr Boston Medical Center