Nurse Case Manager, 40 hours, Days

Beth Israel Lahey Health; Boston (MA); On-site; USD 55,000 - 139,000; Full time

Benefits offered by this job

Vaccination program

Job summary

Beth Israel Deaconess Medical Center, Inc. is seeking a Nurse Case Manager to coordinate discharge planning for inpatient units. You will utilize InterQual criteria for utilization review and work with physician leaders to ensure appropriate levels of care across the hospital.

The role focuses on patient-centered care, outcomes, and collaboration within a multidisciplinary team, with the Nursing Leadership overseeing training and competency development.

Qualifications

• Associates degree in nursing required.
• Bachelor’s degree in nursing preferred.
• Registered Nurse license required.
• 1–3 years related work experience preferred.
• Advanced skills with Microsoft Office applications (Outlook, Word, Excel, PowerPoint or Access).

Responsibilities

• Conducts concurrent daily chart review using InterQual ISD criteria to determine severity of illness and level of service.
• Collaborates with multidisciplinary team to develop treatment plans and contingency plans.
• Leads daily case management rounds on assigned unit and participates in house staff rounds.
• Provides information to obtain continued stay certification and assesses payer and physician information needs.

Skills

Nursing

MS Office

Documentation

Communication

Education

Associate's degree in Nursing

Bachelor's degree in Nursing (preferred)

Tools

InterQual ISD criteria

Job description

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Nurse Case Management is a department of 60 Nurse Case Managers (NCMs) who are responsible for coordinating the discharge planning for BIDMC inpatients. They employ Interqual criteria as a tool for utilization review in determining patients’ levels of care. NCMs partner with physician leaders, take daily calls, consult in challenging situations, and problem-solve with the medical staff. The medical center's case management program is staffed seven days a week, and includes dedicated coverage in the emergency department.

Job Description:

Nurse Case Management is a department of 60 Nurse Case Managers (NCMs) who are responsible for coordinating the discharge planning for BIDMC inpatients. They employ Interqual criteria as a tool for utilization review in determining patients’ levels of care. NCMs partner with physician leaders, take daily calls, consult in challenging situations, and problem-solve with the medical staff. The medical center's case management program is staffed seven days a week, and includes dedicated coverage in the emergency department.

Job Summary:

The BIDMC Nursing Mission is to build on a legacy of nursing excellence by caring with compassion, advancing the art and science of nursing, and advocating for the health of patients, families, and communities. The Nurse Case Manager provides utilization management, care coordination and discharge planning for an assigned patient case load. This role is patient-focused, outcome-oriented and based on a general and speciality professional standards, and functions within a multidisciplinary practice model. Training, evaluation and competencies for this role are overseen by a Nurse Leader to the department.

Essential Responsibilities:

• Conducts concurrent daily chart review, investigating patient history, symptoms, clinical status, and treatment utilizing Interqual ISD criteria as a tool to determine a patient's severity of illness and the intensity of service.
• Works with multidisciplinary team to develop treatment plans, including contingency plans.
• Leads daily case management rounds on assigned unit.
• Participates in house staff rounds.
• Provides necessary information to appropriate organization to obtain continued stay certification; assesses payers' and referring physicians' needs in regard to content and frequency of communications.
• Facilitates early referrals to social work, rehab services, patient advocacy, and quality management as needed.
• Refers cases as appropriate to the Utilization Review Physician for review and determination of need for continued stay or alternate healthcare setting.
• Identifies clinical issues and lapses in standards of care and notifies appropriate parties.

Required Qualifications:

• Associate's degree in Nursing required.
• Bachelor's degree in Nursing preferred.
• License Registered Nurse required.
• 1-3 years related work experience required.
• Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications.
• May produce complex documents, perform analysis and maintain databases.

Preferred Qualifications:

• Certified Case Manager.
• Previous clinical nursing experience and/or case management experience.

Competencies:

• Decision Making: Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area.
• Problem Solving: Ability to address problems that are highly varied, complex and often non-recurring, requiring staff input, innovative, creative, and Lean diagnostic techniques to resolve issues.
• Independence of Action: Ability to set goals and determines how to accomplish defined results with some guidelines. Manager/Director provides broad guidance and overall direction.
• Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.
• Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.
• Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.
• Team Work: Ability to lead and direct multiple collaborative teams for large projects or groups both internal and external to the Medical Center and across functional areas. Results have significant implications for the management and operations of the organization.
• Customer Service: Ability to provide a high level of customer service and staff training to meet customer service standards and expectations for the assigned unit(s). Resolves service issues in the assigned unit(s) in a timely and respectful manner.

Age based Competencies:

Employees in this job must be competent to provide patient care to the following age groups: Neonatal: Birth to 6 months, Young adult: 16-30 years, Middle Age: 30 - 60 years, Elderly: 60 - .

Physical Nature of the Job:

Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally

Pay Range:

$39.14 - $101.14 The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.

Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment. More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger. Equal Opportunity Employer/Veterans/Disabled At Beth Israel Lahey Health, we are driving the change in health care that Massachusetts wants and needs. Our culture promotes continuous learning, growth, innovation and a sense of belonging. We make it a priority to offer comprehensive compensation and benefits and help you achieve a healthy and balanced life. While you're busy caring for and supporting our patients, we take care of you.