RN Care Manager

6 hours ago

Lawrence, United States Lawrence General Hospital Full time

The RN Care Manager collaborates with physicians, nurses, and other clinical staff/directors to coordinate, facilitate and expedite patient care services across the continuum from pre-admission to discharge and continuing care. He/she provides initial leveling of service assignment and monitors patients throughout stay to ensure compliance with payer regulations.

This specific position is based in the Emergency Center and works 2 shifts per week, 7p-7a or 9pm – 9am. Schedule will vary and include weekdays and weekend shifts. Current hospital MNA members eligible to apply.

    • Utilizing Interqual® Level of Care Criteria, ensures appropriate service assignment (inpatient vs observation) and collaborates with attending MD to reduce possibility of reimbursement denials

  • Provides clinical information necessary for authorization to 3 rd parties within one business day of request

  • Communicates excess day and/or denial information to the team; resolves delays by negotiating with the team, ancillary services, 3 rd parties

  • Rounds with the care team and collaborates with the team to identify patient/families with complex discharge needs. Determines appropriate referrals.

  • Ensures patients are discharged appropriately to alternative sites in a timely manner

Qualifications :

  • BSN required; Master’s degree preferred

  • Current Massachusetts Nursing license

  • Minimum 5 years clinical nursing experience

  • 5 years case management experience in an acute care setting with discharge planning, continuing care, care management, and utilization review preferred.

  • Strong verbal and written communications skills

  • Proficiency with computers and an ability to learn new programs with ease.

Lawrence General Hospital is a private, non-profit community hospital providing the Merrimack Valley & southern New Hampshire regions with patient-centered, compassionate and quality health care for the whole family. For over 140 years, the dedicated doctors, nurses, and staff of Lawrence General have been committed to improving the health of the people and communities we serve. We offer competitive pay, a robust benefit package, generous paid time off and free parking We are an Equal Opportunity Employer committed to hiring a diverse workforce.

In 2022 Healthgrades ranked LGH in the top 5 percent of hospitals in the country, and as was awarded a top spot on Forbes’ annual list of America’s Best-In-State Employers 2020

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