Per Diem RN: Case Management & Discharge Navigator

Brigham and Women’s Faulkner Hospital; Boston (MA); On-site; USD 56,000 - 138,000; Part time

Job summary

Brigham and Women's Faulkner Hospital, Inc. is in need of a per diem RN to perform the six essential activities of Case Management and coordinate post-discharge care.

This role requires 3 years of Utilization Review and Case Management experience with a preference for CCM certification, along with a current MA RN license and a BSN. The RN will perform utilization reviews, collaborate with patients and the interdisciplinary team, and manage referrals across post-acute care.

Qualifications

• BSN required.
• Current Registration as a Licensed Nurse in the State of Massachusetts.
• 3 year of Utilization Review and Case Management experience required, 4 or more years preferred
• 5 years of Acute Care Nursing Required 6 or more preferred
• CCM preferred.

Responsibilities

• Perform utilization review to evaluate for appropriate level of care and faxes all insurance reviews timely to prevent denials.
• Collaborate with patient/family and interdisciplinary team to assess for appropriate discharge needs.
• Place and implement all aspects of referrals to all levels of post acute care in 4 Next.
• Online documentation of interaction with patient, family and interdisciplinary team.
• Interact with various third party payers on a daily basis. Fax clinical in payor communication to the right insurer with the right fax number in the right time frame.
• Refer cases not meeting appropriate level of care to the Physician Advisor or EHR.
• Review for Observation status and make changes as needed.

Skills

Utilization review

Case management

Interdisciplinary collaboration

Documentation

Education

BSN required

Massachusetts RN license

Job description

Brigham and Women's Faulkner Hospital, Inc. is in need of a per diem RN to perform the six essential activities of Case Management and coordinate post-discharge care.

This role requires 3 years of Utilization Review and Case Management experience with a preference for CCM certification, along with a current MA RN license and a BSN. The RN will perform utilization reviews, collaborate with patients and the interdisciplinary team, and manage referrals across post-acute care.