RN Case Manager (40hr)

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Job Summary

The RN Case Manager (CM) facilitates the coordination of care for those patients admitted to medical, surgical services, ICU, and as needed for outpatient areas including but not limited to the Emergency Department, PACU and Preadmission testing. The case manager consults and collaborates in activities related to the establishment of appropriate levels of care. He/She reviews patient's medical records and participates in direct and indirect communication with care givers to ensure continued appropriate level of care, including the level of care of elective surgical cases. The case manager provides ongoing education to the physicians and nurses about levels of care. The RN Case manager, performs, consults, and collaborates in activities related to the development of safe effective and efficient discharge or disposition of patients for an assigned patient caseload. This role is patient-focused, outcome-oriented and based on professional nursing practice guidelines and the Standards of Practice for Case Management. And functions within a multidisciplinary practice model.

Essential Responsibilities

• Performs utilization management, care coordination, and discharge planning for assigned patient caseload.
• Coordinates and organizes a timely and accurate review of each medical record for severity of illness and intensity of service, utilizing Interqual criteria, to satisfy state and federal regulations by reviewing and investigating patient history, presenting symptoms, clinical status and treatment.
• Utilizes the case management process of assessment, planning, implementation and evaluation to create case management care plans for assigned patients.
• Facilitates multidisciplinary collaboration on a daily basis.

Required Qualifications

• Associate's degree in Nursing required. Bachelor's degree in Nursing preferred.
• License Registered Nurse required.
• 3-5 years related work experience required in Acute care or managed care setting with two years prior experience in case management.
• Knowledge of discharge planning practices, understanding of utilization review practices including third party payer and insurance plans and acute hospital Interqual, criteria, current knowledge of federal, state, and regulatory requirements guiding case management practice.
• Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.

Competencies

• Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.
• Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
• Independence of Action: Ability to set goals and determines how to accomplish defined results with some guidelines. Manager/Director provides broad guidance and overall direction.
• Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.
• Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.
• Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.
• Team Work: Ability to lead collaborative teams for larger projects or groups both internal and external to the Medical Center and across functional areas. Results have implications for the management and operations of multiple areas of the organization.
• Customer Service: Ability to provide a high level of customer service and staff training to meet customer service standards and expectations for the assigned unit(s). Resolves service issues in the assigned unit(s) in a timely and respectful manner.

Age Based Competencies

Employees in this job must be competent to provide patient care to the following age groups: Neonatal: Birth to 6 months, Youth: 6 months to 16 years, Young adult: 16-30 years, Middle Age: 30 - 60 years, Elderly: 60 -. Physical Nature of the Job: Light work: Exerting up to 20 pounds of force frequently to move objects. Some elements of the job are sedentary, but the employee will be required to stand for periods of time or move throughout the hospital campus.

Pay Range

$37.08 - $92.84

Vaccination Requirements

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

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More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled