RN Care Manager-Care Management (40 Hrs, Days with alt W/E-SEIU)
- Location: Boston, MA
- Posted: Feb 20, 2019
Graduate of an accredited BS program in Nursing preferred.
Licensed to practice professional nursing as a Registered Nurse in the Commonwealth of Massachusetts.
A minimum of 3-5 years recent clinical experience required, and 1-3 years of recent acute, Inpatient Care Management experience required.
Ability to understand confidentiality and the legal and ethical issues pertaining to patient health; understand medical terminology, how to obtain an accurate history; establish treatment goals; establish working relationships with referral sources; develop treatment plans.
Knowledge and understanding of methods for assessing an individual's level of physical/mental impairment; understand the physical and psychological characteristics of illness; ability to assist individuals with the development of short- and long-term health goals.
Ability to understand the requirements for prior approval by payer; be able to evaluate the quality of necessary medical services; be able to acquire and analyze the cost of care; understand the various health care delivery systems and payer plan contracts; be able to demonstrate cost savings.
Ability to understand case management philosophy and principles; apply problem solving techniques to the care management process; document care management services; understand liability issues for care management activities.
Knowledgeable on how to access and evaluate the available resources to meet a client's needs; able to develop new resources.
Excellent interpersonal, verbal, and written communication and negotiation skills
Strong analytical, data management and PC skills.
Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.
Understanding of pre-acute and post-acute venues of care and post-acute community resources.
Strong organizational and time management skills, as evidenced by a capacity to prioritize multiple tasks and role components.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.The RN will provide care management intervention in collaboration with the care team.
The care manager ensures the patients progress through the system in an efficient and cost effective manner.
The Care Manager remains involved in the patients care from admission and during the evaluation phase of discharge planning and will make recommendations for the discharge plan based on the assessment.
The Care manager serves as a resource for utilization management, i.e., level of care and assignment of appropriate status.
- Full time