Nurse Case Manager
5 days ago
Mass General Brigham is seeking a skilled Registered Nurse to join our team as a Case Manager. This role will be responsible for coordinating care for patients from admission through discharge, with a focus on achieving realistic treatment outcomes within available resources.
Key Responsibilities:- Conduct assessments of patients' health and psychosocial needs in accordance with established guidelines.
- Develop and implement case management plans in collaboration with the interdisciplinary team, patients, and families to maximize healthcare responses, quality, and cost-effective outcomes.
- Promote communication and coordination between team members, payers, and community resources to minimize fragmentation of services and achieve optimal outcomes.
- Plan and conduct patient-centered team meetings to coordinate healthcare team members and third-party payers to achieve treatment outcomes and discharge planning goals.
- Provide education to the interdisciplinary team, patients, and families about treatment options, community resources, insurance benefits, and psychosocial concerns to ensure timely and informed decisions.
- Empower patients and families to problem-solve and achieve desired outcomes, promoting patient self-determination.
- Ensure appropriate use of healthcare services and allocation of resources to improve quality of care and maintain a balance with cost-effective care on a case-by-case basis.
- Identify and provide access to resources for discharge services, promoting a safe transition to the next most appropriate level of care.
- Develop discharge plans in collaboration with the healthcare team and family, meeting patient needs and financial requirements.
- Provide culturally competent care, incorporating patients' cultural needs into the development of discharge plans.
- Ensure a smooth transition from acute settings through skilled nursing stays and discharge, using established standards.
- Document care in adherence to department standards.
- Adhere to third-party coverage guidelines for each patient situation.
- Complete additional department, organization, or network activities as per established objectives.
- Uphold the PCC Organizational Values of Innovation, Collaboration, Accountability, Respect, and Excellence.
- 5 years of related experience.
- Case management, utilization review, or discharge planning experience in an acute, rehabilitation, skilled nursing, or outpatient setting is required.
- Preferred: Health plan experience in utilization review and case management will be considered.
- Licensure: Current, unrestricted license to practice in Massachusetts in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice of the discipline.
- Preferred Skills: Certification in Case Management, knowledge of community services and healthcare systems, knowledge of criteria and levels of care, computer proficiency, and Microsoft office applications.
Mass General Brigham provides a welcoming environment to employees, patients, and families of diverse cultures, ethnic backgrounds, ages, lifestyles, and physical abilities. Our hospitals are consistently ranked as top hospitals by U.S. World News Report.
Benefits include medical, dental, vision, life insurance, employee assistance programs, and more.
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