Job Description

Summary:

Case Manager for inpatient medical units and Emergency Department.

Responsibilities:

ò Develops case management plan to satisfy JCAHO and payer requirements.
ò Conducts concurrent utilization review on all inpatients.
ò Uses high risk screening mechanisms to determine the final discharge plan in cooperation with patient/patient representative, physician and other professional disciplines.
ò The plan contains an assessment of appropriateness of services to meet the particular patient needs.
ò Participates in daily patient care conferences, as needed, on each assigned unit, acting as a member of the multidisciplinary team that assesses the needs of the patient.

Qualifications:

Qualifications: Bachelor's in Nursing preferred and Masters preferred ( Nursing Masters not required for this advanced degree) . InterQual experience. Strong computer skills with knowledge and proficiency with Microsoft Word, Excel and PowerPoint. Strong data analytic skills to prepare and monitor management reports regarding the performance of the areas assigned and the Department. Demonstrated experience with managing against clinical and financial indicators and performance goals. Demonstrated skills in working collaboratively with physicians, managers and other team members. Demonstrated skills in organizing and directing staff teams to complete assignments accurately and on time. Exempt position. Recent experience in acute care setting involved with clinical activities and/or a managed care environment working in case management. Recent experience in a case management role or related role. Excellent computer skills including managing work against performance metrics and reporting on key indicators important to the department. Current licensure in Massachusetts as a Registered Nurse. Case Management Certification preferred. Evidence of continued professional development.

Application Instructions

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