Case Manager

RN Case Manager

Utilizing a collaborative process the care manager will assess plan implement monitor and evaluate the options and services required to meet an individuals 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.

Position: RN Case Manager

Department: 7W

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

Job Requirements

Education: Graduate of an accredited ASN/BSN Program in Nursing

Certificates Licenses Registrations Required: 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

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.

Strong communication collaboration and problem-solving skills

Knowledge of utilization review discharge planning managed care and community resources

Knowledge and Skills

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

Compensation Range: 38.05- 75.33

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

According to the FTC there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications or apps job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.