Description
RN Case Manager
South Shore Health
Weymouth, MA
At South Shore Health, we come together to improve the health of our family, friends and neighbors by bringing together people, caregivers and excellence in medicine. We are seeking RN Case Managers (Full-Time and Per Diem) to work autonomously to coordinate, negotiate, manage, and procure services and resources for the care of complex patients and facilitate achievement of quality and cost-efficient patient outcomes. The ideal candidate will coordinate patient care across the healthcare continuum, ensuring optimal outcomes, efficient resource utilization, and a high standard of patient satisfaction. This is an on-site role with rotating weekends and occasional holiday coverage offering an annual pay range of $117,707.20 - $170,768.00.
Responsibilities:
Apply review criteria to determine medical necessity for admission and continued stay, providing pre-admission evaluation, clinically based case screening management, discharge planning and care coordination to facilitate the delivery of cost-effective quality healthcare
- Establish and maintain effective communication with all referral sources, insurers, vendors, and patient supplier systems and work collaboratively with interdisciplinary internal/external staff to assist in the identification of appropriate resource usage across the continuum of care
- Assess patient acute level of care needs and work to implement and coordinate interventions aimed at facilitating a safe and timely discharge plan to the appropriate sub-acute settings in collaboration with the Case Manager Specialist
- Ensure patients receive all information related to choice of follow-up care facilities according to patient/family preference and any ACO-preferred contracted providers
Demonstrate professional commitment to institution’s and department’s goals and objectives and maintain flexibility to the department’s needs in relation to floor and work schedules, along with any other internal/external demands of the department
- Maintain an updated knowledge base and reference resource outlining provider benefits for care choices, including public, private, and governmental payers and established/preferred ACO relations
- Oversee department operational excellence regarding safe and effective discharge planning and the delivery of quality services in accordance with applicable policies, procedures and professional standards
Qualifications:
- Must be licensed as a Registered Nurse in the State of Massachusetts; bachelor’s degree strongly preferred
- 3-5 years of acute care hospital experience preferred; Critical Care or Emergency Department experience desired
- Accredited Case Manager (ACM) or Certified Case Manager (CCM) required or obtained within two years of hire; National Board for Case Management (NBCM) and Commission for Case Manager (CCMC) certification preferred
- Demonstrated skills in negotiation, verbal/written communication, conflict management, interdisciplinary collaboration, and time management and ability to multitask in high-stress environments
- Knowledge of healthcare financing, post-acute community care, utilization management (third-party payers), patient care processes, and data analysis
More About South Shore Hospital
South Shore Hospital is Southeastern Massachusetts’s leading provider of emergency, acute and outpatient care. We are consistently recognized for quality of care, including being recognized as a Top General Hospital by the Leapfrog Group. Our hospital has also received Magnet Recognition Program designation, a distinction only 8% of U.S. hospitals achieve. Join us in providing world-class care to the communities of the South Shore.
Living On the South Shore
Located South of Boston, but within easy driving or boating distance of greater New England, the South Shore is a wonderful place to live. No matter your interest: history, the beach, music, art, shopping, fine cuisine, foliage, sports – we have it all. And with some of the best schools in the country, from kindergarten to college, this is a great place to raise a family.
To apply, please visit: https://southshorehealth.wd5.myworkdayjobs.com/SSH_Careers/job/Weymouth-MA/RN-Case-Manager-1_R-22693
Req# R-22693
careers.southshorehealth.org
EOE
