RN Case Manager
2 weeks ago
Mass General Brigham is seeking a skilled RN Case Manager to join our team on a per diem basis. As a RN Case Manager, you will play a critical role in planning, developing, and organizing the operations of the Case Management Department.
Responsibilities:- Assist in planning, developing, and organizing the operations of the Case Management Department.
- Perform all admission/continued stay reviews for appropriateness of acute hospital level, assessing quality of services as the patient moves through the continuum of care.
- Communicate with the interdisciplinary team and community resource representatives in planning for the patient's transition to post-hospital care.
- Develop and implement departmental and interdepartmental policies and procedures relating to Case Management and the Swing Bed Program.
- Coordinate the Hospital's Swing Bed Program.
- Review the medical/surgical treatment plan with third party payors to obtain authorization for pre certification, admission and continued stay.
- Establish individual patients discharge plans to provide transition to outpatient or extended care providers.
- Coordinate/provides social and practical assistance with environmental problems including financial assistance, discharge planning and referrals to other community agencies.
- Works closely with the patient/representative and family to identify the appropriate health and social service agencies for continuing care post-hospital.
- Provides the required discharge documentation (patient care referrals, STAT discharge summaries) to community agencies and extended care facilities at the time of discharge in cases requiring post hospital care.
- Arranges air or ground transportation to other facilities.
- Completes occurrence screens as part of the Hospital's patient safety program.
- Educates Medical and Nursing Staffs on Interqual criteria and appropriate documentation for acute hospital care.
- Pre-screens patients for respite care/swing bed admissions, collaborating with Clinical Coordinator/Nursing Supervisor on appropriateness.
- Coordinates appeal process for reimbursement denials with Medical Staff, Billing, and Medical Records.
- Registered Nurse with previous case management experience required.
- Successful completion of Case Management Certification Program preferred.
- Prior work in a community health, home health, or acute care or critical access hospital setting.
At Mass General Brigham, we are committed to providing high-quality, safe, and accessible care to our patients. We are seeking a skilled RN Case Manager to join our team and contribute to our mission.
We offer a competitive compensation package, including medical benefits, dental benefits, and employee assistance programs. If you are a motivated and experienced RN Case Manager looking for a new challenge, we encourage you to apply.
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