RN Care Manager, Care Management, 20 Hours

3 weeks ago

Boston, United States Boston Medical Center (BMC) Full time

Job Description:

RN Care ManagerCare Management Part TimeEvery Weekend, Saturday and Sunday, 10 Hour ShiftsUtilizing a collaborative process, the RN Care Manager will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual’s 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. The RN Care Manager is dedicated to handle the increased volume and to support the overall care management process and the department.Position SummaryUtilizing a collaborative process, the care manager will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual’s 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 Care ManagerDepartment: Care ManagementSchedule: 20 Hours (Every Weekend)EducationJOB REQUIREMENTSNursing degree: Diploma, ASN or BSN (preferred), Ability to obtain BSN within 4 yearsCertificates, Licenses, Registrations RequiredLicensed to practice as a Registered Nurse in the commonwealth of MassachusettsCCM or related certification attained within 24 months from the hire date is preferredExperience3-5 years of diversified clinical experience is requiredA minimum of 2 years of previous experience involving judgment and decision making, preferably in a utilization management/case management positionKnowledge And SkillsExtensive background and knowledge of current medical/surgical patterns of practice.Medical terminology and standard medical abbreviations.Managed care concepts, the various health care delivery systemsMethods 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 ProgramExcellent interpersonal, verbal and written communication and negotiations skillsStrong analytical, data management and PC skillsEqual Opportunity Employer/Disabled/Veterans

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