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Nurse Case Manager

Role overview

Qualifications

  • Associate's Degree Nursing required or Bachelor's Degree Nursing preferred
  • Registered Nurse [RN - State License] required
  • Basic Life Support [BLS Certification] preferred
  • 2-3 years case management, utilization review, or discharge planning experience preferred

Responsibilities

  • Client Assessments and Planning - Modify patient treatment plans as indicated by patients' responses and conditions
  • Prepare patient/family for discharge
  • Communicates with third party payers to obtain necessary authorization for reimbursement of services
  • Review cases with medical directors on challenging cases as needed

Key facts

Other skills

  • Microsoft Office
  • Client Confidentiality
  • Detail Oriented
  • Logical Reasoning
  • Relationship Building
  • Problem Solving

About the company

Brigham and Women's Hospital logo

Brigham and Women's Hospital

Boston's Brigham and Women's Hospital (BWH) is an international leader in virtually every area of medicine and has been the site of pioneering breakthroughs that have improved lives around the world. A major teaching hospital of Harvard Medical School, BWH has a legacy of excellence that continues to grow. With two outstanding hospitals, over 150 outpatient practices, and over 1,200 physicians, we serve patients from New England, throughout the United States, and from 120 countries around the world. The BWH name is a reflection of our history. In 1980 three of Boston’s oldest and most prestigious Harvard Medical School teaching hospitals - the Peter Bent Brigham Hospital, the Robert Breck Brigham Hospital, and the Boston Hospital for Women – merged to form Brigham and Women’s Hospital. As a national leader in improving health care quality and safety, we have helped to develop some of the industry’s best practices including computerized physician order entry (CPOE) to prevent medication errors. The CPOE is now a nationally-accepted safety practice. The BWH Biomedical Research Institute (BRI) is one of the most powerful biomedical research institutes in the world and the second largest recipient of National Institutes of Health (NIH) funding among independent hospitals in the United States. BWH has long had great success in research as measured by the number of important discoveries made, the size and scope of its research portfolio and the volume of publications annually. BWH is a training ground for physicians, nurses, and allied health professionals. We have 1,100 trainees in over 140 of the most sought after training programs in the world, and also host Harvard Medical School students in rotations throughout our programs. As our global health services expand, our clinical trainees have rich opportunities to contribute and learn in challenging environments around the world. Brigham and Women's Hospital is an EEO, AA, VEVRAA Employer.

Company details

Company size10001

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Job description

Site: Martha's Vineyard Hospital, Inc.


 

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.


 

24 hour hours per week; weekend and holiday ; 2 days on site


 

Job Summary

Serves as a core member of the care team coordinates and supports healthcare within the facility, and coordinates referrals for services outside the clinic. Provides outreach and enrollment services to meet eligibility requirements of the program and surrounding counties. Ensures coordination and planning, including community and family support. Focuses on the development and coordination of community service plans. Partners with service providers, families, and patients to create a plan of healthcare and identify additional service providers.

Does this position require Patient Care?Yes

Essential Functions<br>-Client Assessments and Planning
-Modify patient treatment plans as indicated by patients' responses and conditions.
-Prepare patient/family for discharge
-Communicates with third party payers to obtain necessary authorization for reimbursement of services.
-Review cases with medical directors on challenging cases as needed
-Defines care goals of patients by providing education, information, and direction to each individual and family.
-Maintain accurate, detailed reports and records.
-Communicates with third party payers to obtain necessary authorization for reimbursement of services.


 

Qualifications

Education Associate's Degree Nursing required or Bachelor's Degree Nursing preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Registered Nurse [RN - State License] - Generic - HR Only required Basic Life Support [BLS Certification] - Data Conversion - Various Issuers preferred Experience Case management, utilization review, or discharge planning experience 2-3 years preferred Knowledge, Skills and Abilities - Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times. - Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems. - Ability to establish strong rapport and relationships with patients and staff. - Proficient in Microsoft Office and industry related software programs. - Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions. - Ability to maintain client and staff confidentiality. - Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care. - Knowledge of Healthcare and Managed Care preferred.


 

Additional Job Details (if applicable)

Physical Requirements
  • Standing Frequently (34-66%)
  • Walking Frequently (34-66%)
  • Sitting Occasionally (3-33%)
  • Lifting Frequently (34-66%) 35lbs+ (w/assisted device)
  • Carrying Frequently (34-66%) 20lbs - 35lbs
  • Pushing Occasionally (3-33%)
  • Pulling Occasionally (3-33%)
  • Climbing Rarely (Less than 2%)
  • Balancing Frequently (34-66%)
  • Stooping Occasionally (3-33%)
  • Kneeling Occasionally (3-33%)
  • Crouching Occasionally (3-33%)
  • Crawling Rarely (Less than 2%)
  • Reaching Frequently (34-66%)
  • Gross Manipulation (Handling) Frequently (34-66%)
  • Fine Manipulation (Fingering) Frequently (34-66%)
  • Feeling Constantly (67-100%)
  • Foot Use Rarely (Less than 2%)
  • Vision - Far Constantly (67-100%)
  • Vision - Near Constantly (67-100%)
  • Talking Constantly (67-100%)
  • Hearing Constantly (67-100%)

  •  

    Remote Type

    Remote


     

    Work Location

    One Hospital Road


     

    Scheduled Weekly Hours

    24


     

    Employee Type

    Regular


     

    Work Shift

    Day (United States of America)



     

    Pay Range

    $58,656.00 - $142,448.80/Annual


     

    Grade

    98TEMP


     

    At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.


     

    EEO Statement:

    Martha's Vineyard Hospital, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.


     

    Mass General Brigham Competency Framework

    At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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    Marcus Rivera

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    m.rivera@company.com
    linkedin.com/in/marcusrivera
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