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RN Case Manager
2 months ago
We are seeking a skilled RN Case Manager to join our team at Wentworth-Douglass Hospital, an affiliate of Mass General Brigham. As a RN Case Manager, you will play a critical role in coordinating patient care and ensuring seamless transitions between healthcare settings.
Key Responsibilities- Facilitate coordination of care for patients along the healthcare continuum, ensuring timely and effective transitions between healthcare settings.
- Meet directly with patients and families to assess needs and develop individualized plans in collaboration with healthcare providers.
- Refer cases for social work interventions and collaborate with external case managers as needed.
- Initiate and facilitate referrals for home healthcare, hospice, DME, and pharmacy services.
- Communicate and collaborate with all members of the healthcare team, including patients, payers, and administrators, regarding patient needs, plans, and responses.
- Demonstrate professionalism with managed care entities and processes, staying informed of changes in contractual relationships for all payer systems.
- Provide requested information regarding patient care and services to external review and regulatory agencies.
- Coordinate and perform all follow-up activities related to Medicare, other third-party payers, and hospital-negotiated contracts.
- Communicate changes in review findings to patients, MDs, and other appropriate personnel, resulting in level of care changes or findings consistent with termination or denial of benefits.
- Demonstrate excellence in leadership skills and professional performance, maintaining close communication with ED Director/coordinator regarding utilization, quality of care, risk, and infection control issues.
- Participate in departmental and hospital committees, ad hoc committees, task forces, and work groups, educating health team colleagues about Case Management and the needs of the case-managed population.
- Collect data pertinent to care management, utilization management, and performance improvement, reporting adverse drug reactions and issues related to infection control/surveillance.
We invite you to explore opportunities at Wentworth-Douglass Hospital, where we value people who contribute to patient-centered care that enhances community health. If you are a motivated and compassionate RN with excellent communication skills, we encourage you to apply for this exciting opportunity.
