RN, Hospital Case Manager, Part Time

2 days ago


Springfield, Illinois, United States Baystate Health Full time
Hospital Case Manager Job Description

The Hospital Case Manager is a registered nurse responsible for coordinating clinical care, quality, and financial outcomes of a designated population of patients.

Key Responsibilities:
  • Facilitate patient care plans as outlined in the plan of care
  • Lead daily patient care huddles with nursing to direct timely progress along the continuum
  • Work cooperatively as a leading member of the healthcare team to ensure appropriate use of hospital resources, patient satisfaction, and achievement of quality of care
  • Manage input from all healthcare professionals and conduct assessments to determine patient healthcare and transitional needs
  • Evaluate and ensure appropriateness of admissions and continued stay using evidence-based criteria
  • Collaborate and manage outcomes with payers through ongoing written and verbal communications to appropriate parties
  • Lead discussions with physician advisors and MDs about safe plans for transitions
  • Lead the team to ensure appropriate utilization of patient resources and direct care to other settings when appropriate
  • Collaborate with community case managers and other healthcare advisors to ensure a smooth and safe continuum of care
  • Conduct extensive assessments and implement interventions for patients at risk for readmissions
  • Manage concurrent denials and work with physicians to overturn for appropriate reimbursement
Requirements:
  • MA RN License, BSN preferred
  • 3-5 years clinical nursing experience
  • Hospital Case Management, Care Coordination experience strongly preferred
  • Certification in Case Management preferred
About Baystate Health

At Baystate Health, we believe that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.

We are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.



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