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Nurse Case Manager
2 months ago
Mass General Brigham is seeking a skilled Registered Nurse to fill a Case Management position in Everett, Massachusetts.
Job SummaryWe are looking for a dedicated and compassionate Registered Nurse to join our team as a Case Manager. As a Case Manager, you will be responsible for coordinating patient care, from admission through discharge, with a focus on achieving realistic treatment outcomes within the scope of available resources.
Key Responsibilities- Assess patient health and psychosocial needs according to established guidelines.
- Develop a case management plan collaboratively with the interdisciplinary team, patient, and family to maximize healthcare responses, quality, and cost-effective outcomes.
- Communicate and coordinate with the interdisciplinary team, payer, and community to minimize fragmentation of services and maximize 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, patient, and family 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.
- Encourage the 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 resources for discharge services, promoting a safe transition to the next most appropriate level of care.
- Develop a discharge plan in collaboration with the healthcare team and family, meeting patient needs and financial requirements.
- Display culturally competent care, identifying patient cultural needs and incorporating them into the discharge plan.
- Provide patient education and support to ensure a smooth transition from the acute setting, through the SRN stay, and to discharge, using established standards.
- Complete documentation in adherence to department standards.
- Adhere to third-party coverage guidelines for each patient situation.
- Complete additional department, organization, or network activities per established objectives.
- Uphold PCC Organizational Values of Innovation, Collaboration, Accountability, Respect, and Excellence.
- Education/Degree Required: 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.
- Experience Required: 5 years of related experience, with case management, utilization review, or discharge planning experience in an acute, rehabilitation, skilled nursing, or outpatient setting.
- Preferred Experience: Health plan experience in utilization review and case management.
- Preferred Skills: Certification in Case Management, knowledge of community services and the healthcare system, knowledge of criteria and levels of care, computer proficiency, and highly developed communications and interpersonal skills.
Mass General Brigham is a leading healthcare organization dedicated to providing high-quality, safe, and accessible care to patients and communities. We are committed to innovation, collaboration, accountability, respect, and excellence in all aspects of our work.
Benefits- Medical benefits
- Dental benefits
- Vision benefits
- Life insurance
- Employee assistance programs
