Facilitates patients care plan as called for in the plan of care
Leads daily patient care huddles with nursing to direct timely progress along the continuum
Evaluates and ensures appropriateness of admissions and continued stay using evidence based criteria
Collaborates and manages outcomes with the payers through ongoing written and verbal communications to appropriate parties
Leads discussions with Physician advisors and MD's about safe plan for transitions
Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate
Collaborates with community case managers and other health care advisors to ensure a smooth and safe continuum of care plan
Conducts extensive assessments and implements interventions for patients at risk for readmissions
Manages concurrent denials and works with physicians to overturn for appropriate reimbursement
Required Work Experience:
BSN required
3-5 years clinical Nursing experience
Hospital Case Management, Care Coordination experience strongly preferred
Skills and Competencies:
Requires a working knowledge of community resources and Utilization/Quality Review standards and activities conducted by third party payers
Ability to organize and prioritize workload in order to meet deadlines
Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third party payers where appropriate
Excellent computer skills
Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third party payers where appropriate
Schedule & Location
Per Diem
Rotating weekends = to approx. 6 weekends a year
Rotating holiday = 1 holiday year
Baystate Medical Center 759 Chestnut Street Springfield, MA
THE ADVANTAGES OF WORKING WITH BAYSTATE!
Excellent Compensation
High-quality, low-cost medical, dental and vision insurance
Pet, home, auto and personal insurance
Certification and continuing education reimbursement
403b retirement company match & annual company contribution increase based on years of service
Life insurance
Free money coach advice from a certified professional
Reimbursement for a variety of wellbeing activities, included but limited to: gym membership and equipment, personal trainer, massage and so much more!
Wellbeing programs that include but are not limited to mental, physical, and financial health
We strive to be the place where we can help you build the career you deserve - apply today - YOU belong at Baystate!
Our compensation philosophy
Minimum - Midpoint - Maximum
$47.14 - $56.99 - $70.72
Benefits
Health insuranceDental insuranceVision insurance
Additional Information
Per Diem Hospital Case Manager
The RN Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that will ensure continuity and effective community or post acute reentry. The Hospital Case Manager leads the interdisciplinary team in developing complex discharge plans.
Baystatehealth · Springfield, MA