Hospital Case Manager
Per Diem
The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that will ensure continuity and effective community or post acute reentry. The Hospital Case Manager leads the interdisciplinary team in developing complex discharge plans.
Facilitates patients care plan as called for in the plan of care
Leads daily patient care huddles with nursing to direct timely progress along the continuumWorks cooperatively as a leading member of the health care team to insure appropriate use of hospital resources, patient satisfaction, and achievement of quality of care. Manages input from all health care professionals and conducts assessments to determine patients health care and transitional needs. SuEvaluates and ensures appropriateness of admissions and continued stay using evidence based criteriaCollaborates and manages outcomes with the payers through ongoing written and verbal communications to appropriate partiesLeads discussions with Physician advisors and MD's about safe plan for transitionsLeads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriateCollaborates with community case managers and other health care advisors to ensure a smooth and safe continuum of care planConducts extensive assessments and implements interventions for patients at risk for readmissionsManages concurrent denials and works with physicians to overturn for appropriate reimbursementRequired Work Experience :
MA RN License, BSN preferred5 years clinical Nursing experienceHospital Case Management, Care Coordination experience strongly preferredCertification in Case Management preferredSkills and Competencies :
Requires a working knowledge of community resources and Utilization / Quality Review standards and activities conducted by third party payersAbility to organize and prioritize workload in order to meet deadlinesMust possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third party payers where appropriateExcellent computer skillsMust possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third party payers where appropriateOther Information
per diemWeekday, Weekends and holidayAdvantages of Working with Baystate Health
Established career ladders with guaranteed compensation increases.Excellent Benefits, Compensation and generous PTOTuition ReimbursementFirst time home buyers' programHigh-quality, low-cost medical, dental and vision InsuranceCompetitive 403b retirement matchWellbeing programs that include but are not limited to mental, physical and financial health.Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
