Nurse Case Manager

4 weeks ago

Somerville, Massachusetts, United States Mass General Brigham Full time
Job Title: Registered Nurse - Case Management

Mass General Brigham is seeking a skilled Registered Nurse to join our team as a Case Manager. This is a full-time position with a 40-hour workweek, working 8-hour days.

Job Summary:

The successful candidate will be responsible for facilitating the coordination of care for patients, from admission through discharge, with a focus on achieving realistic treatment outcomes within the scope of available resources. This will involve assessing patients' health and psychosocial needs, developing and implementing case management plans, and collaborating with the interdisciplinary team, patients, and families to ensure timely and appropriate discharge planning and cost-effective outcomes.

Key Responsibilities:
  • Assess patients' health and psychosocial needs in accordance with established guidelines.
  • Develop and implement case management plans in collaboration with the interdisciplinary team, patients, and families to maximize healthcare responses, quality, and cost-effective outcomes.
  • Communicate and coordinate with members of the interdisciplinary team, payers, and community to minimize fragmentation of services and maximize outcomes.
  • 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, patients, and families about treatment options, community resources, insurance benefits, and psychosocial concerns to ensure timely and informed decisions.
  • Empower patients and families to problem-solve to achieve desired outcomes and promote 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 access to appropriate resources to promote a safe transition to the next most appropriate level of care.
  • Develop discharge plans in collaboration with the healthcare team and family that meet patients' needs and financial requirements.
  • Provide culturally competent care to identify patients' cultural needs and incorporate them into the development of 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.
  • Document care in adherence to department standards.
  • Adhere to third-party coverage guidelines for each patient situation.
  • Complete additional department, organization, or network activities as per established objectives.
  • Uphold the organizational values of innovation, collaboration, accountability, respect, and excellence.
Qualifications and Experience:
  • Education: Bachelor's degree in a related field. Master's degree in a related field is preferred.
  • Experience: 3-5 years of related experience. Case management, utilization review, or discharge planning experience in an acute, rehabilitation, skilled nursing, or outpatient setting is required. Health plan experience in utilization review and case management will be considered.
  • Licensure: 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.
Skills:
  • Knowledge of community services and the healthcare system.
  • Knowledge of criteria and levels of care.
  • Computer proficiency, with Microsoft Office applications preferred.
  • Certification in case management is preferred.
  • Highly developed communication and interpersonal skills, working with diverse populations.
  • Ability to work independently, be self-directed, and contribute as a member of a team.
  • Anticipates challenges and develops and implements strategies for addressing them.
  • High level of service delivery.
  • Ability to prioritize work, meet deadlines, and adapt to changing situations.
  • Attention to detail.
About Mass General Brigham:

Mass General Brigham is a leading healthcare system that provides a welcoming environment to employees, patients, and families of diverse cultures, ethnic backgrounds, ages, lifestyles, and physical abilities. Our hospitals are consistently ranked as top hospitals by U.S. World News Report.

Benefits:
  • Medical benefits.
  • Dental benefits.
  • Vision benefits.
  • Life insurance.
  • Employee assistance programs.

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