RN - Case Manager

Case Manager

The Case Manager is responsible for managing the healthcare needs, facilitating and achieving quality and cost outcomes for all patients across the continuum. Utilizing a multidisciplinary team approach, the Case Manager negotiates, procures, coordinates, and monitors services and resources necessary for patients.

Responsibilities:

• Review patient needs at admission and continuously throughout the hospital stay for appropriate level of care and resource utilization.
• Perform transition care planning activities to secure appropriate post-hospital care arrangements.
• Monitor patients during their hospitalization to ensure quality care.
• Participate in performance improvement initiatives.

Qualifications:

• Minimum of 3 years of clinical experience in acute care, with a background in areas such as internal medicine, surgery, orthopedics, mother/child, cardiology, or oncology.
• Experience in Rehabilitation Settings, Home Health, or Long-Term Care is also considered.
• Able to perform comprehensive admission and discharge risk assessments concerning quality, financial aspects, payer benefit allowances and limitations, risk management, and patient satisfaction.
• Knowledge of regulatory and accreditation organizations is preferred.
• Certifications such as CCMACM (Certified Case Manager) or RN-BC (Registered Nurse, Board Certification in Case Management) are preferred.
• Experience with Meditech Expanse software is highly preferred.
• Must possess strong organizational skills, data management skills, and proficiency in computer usage for managing multiple applications.
• Excellent interpersonal and communication skills with the ability to maintain confidentiality.
• Ability to establish and maintain relationships with physicians and stakeholders.
• Comprehensive knowledge of local community resources and regulatory requirements related to Medicare, Medicaid, and third-party commercial payers.

Additional Requirements:

• Must have own vehicle for travel as necessary.
• All requested time off (RTO) must be included in the profile at the time of submission.

This position requires commitment to maintaining high-quality patient care and outcomes through effective case management practices.

Client Details City Pittsfield State MA