Job Description

Location: Saint Anne's Hospital
Posted Date: 1/8/2020

POSITION SUMMARY:
The RN Case Manager is responsible for overseeing the appropriateness of care provided to members of health plans contracted by the hospital and is accountable for appropriate financial and clinical outcomes of these patients. The RN Case Manager will be assigned to selected areas of the Hospital on a rotating basis to perform utilization reviews and other Utilization Management activities, as needed based upon department staffing and coverage. The RN Case Manager will support and coordinate the activities of the Social Workers assigned to the unit. As this is an evolving position, duties and responsibilities may vary based on specific assignments.

REQUIRED KNOWLEDGE & SKILLS:

- Strong understanding of managed care
- Sound clinical judgment
- Entrepreneurial
- Excellent function development and management skills
- Excellent communication and negotiation skills
- Relationship manager - providers, committees, payers
- Strong organizational skills

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

Education: Bachelor of Nursing Degree
Experience: At least 3 to 5 years of case management and managed care experience
Certification/Licensure: Current Massachusetts license in nursing. Certification in Case Management Preferred

Application Instructions

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