Case Manager Per Diem Days Specialist

4 days ago


Worcester, Massachusetts, United States Saint Vincent Hospital Full time
Job Title: RN Case Manager

At Saint Vincent Hospital, we are seeking a skilled RN Case Manager to join our team. As a key member of our healthcare team, you will play a vital role in ensuring that our patients receive the highest quality care.

Job Summary:

The RN Case Manager is responsible for coordinating care along a continuum to help patients achieve optimal health and access to care. This includes ensuring that care is provided at the appropriate level of care based on medical necessity and assessing patients for transition needs to promote timely throughput, safe discharge, and prevent avoidable readmissions.

Key Responsibilities:
  • Accurate medical necessity screening and submission for Physician Advisor review
  • Care coordination and transition planning assessment and reassessment
  • Implementation or oversight of implementation of the transition plan
  • Leading and facilitating multi-disciplinary patient care conferences
  • Managing concurrent disputes and making appropriate referrals to other departments
  • Identifying and referring complex patients to Social Work Services
  • Communicating with patients and families about the plan of care
  • Collaborating with physicians, office staff, and ancillary departments
  • Leading and facilitating Complex Case Review
  • Assuring patient education is completed to support post-acute needs
  • Timely and complete documentation in Case Management system
  • Maintenance of accurate patient demographic and insurance information
  • Identification and documentation of potentially avoidable days
  • Identification and reporting over and underutilization
Requirements:
  • Graduate of an accredited school of nursing
  • 2 years of acute hospital patient care experience
  • Active RN license for state(s) covered
Preferred Qualifications:
  • Academic degree in nursing (bachelor's or master's)
  • Acute hospital case management experience
  • Accredited Case Manager (ACM) certification

Saint Vincent Hospital is an equal opportunity employer and complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date.

Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date.

Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.


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