Registered Nurse Complex Care BWH

massgeneralbrigham; Boston (MA); Hybrid; USD 90.000 - 130.000; Vollzeit

Zusammenfassung

The Brigham and Women's Hospital, Inc. is seeking a Complex Care Case Manager to support case managers with complex discharges and to optimize care transitions.

You will work under the Case Management Director to advance care progression initiatives and partner with nursing leadership, physicians, and external partners. The role requires RN licensure in Massachusetts and extensive experience in inpatient case management and discharge planning, with a focus on high-quality, timely patient care

Qualifikationen

• Bachelor's Degree in Nursing required.
• Master's Degree in Nursing preferred.
• Current RN license in Massachusetts.
• ACM-RN/ACM/CMAC/CMGT-BC preferred.
• 5–7 years inpatient case management experience required.
• Experience in discharge planning and post-acute resources required.

Aufgaben

• Acts as case manager expert and mentor for complex care transitions.
• Co-manages with unit-based case managers and collaborates with interprofessional teams.
• Identify discharge barrier mitigation strategies to ensure care progression.
• Develop and share escalation pathways for case management.
• Mentor clinical teams on complex post-acute discharge planning.
• Monitor performance of initiatives and propose improvement opportunities.
• Stay updated on regulations, payer requirements, and accreditation standards.

Kenntnisse

Case Management

Discharge planning

Interdisciplinary teamwork

Regulatory knowledge

Communication skills

Problem-solving

Ausbildung

Bachelor's Degree in Nursing

Master's Degree in Nursing (preferred)

Tools

Electronic Medical Records

Utilization review systems

Jobbeschreibung

Site: The Brigham and Women's 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.

Job Summary

Summary: The Complex Care Case Manager supports case managers in designated areas with complex patient discharges and is an integral part of the Case Management Department. The role reports to Case management nursing Director, with primary efforts focused on supporting patient care progression initiatives and optimal transitional care planning. The Complex Care Case Manager is responsible for researching resources, identifying, and optimizing complex discharge plans for unique patients and groups of patients who often experience barriers to care progression. The role provides day-to-day support and guidance to the nurse case managers and serves in a consultative role to other interprofessional team members, including nursing leadership, physician leadership, hospital administrators, and external community partners.

Does this position require Patient Care? Yes

Essential Functions

Acts as a case manager expert and mentor, independently identifying and resolving issues that impact the quality, safety, and timeliness of care transitions, and escalates to involved stakeholders as appropriate.

• Co-manages with unit-based case managers complex patient care discharges and collaborates with interprofessional clinical teams both internally (i.e. patient financial services, physical therapy) and externally.
• Through participation in routine huddles, rounds, and service line meetings, identifies potential discharge barrier mitigation strategies to ensure care progression and safe care transitions, maximizing all MGB programs.
• Identifies new internal and external escalation pathways and shares with the case management team, providing valuable resources and updates.
• Responsible for executing, socializing, and enforcing best practices related to case management with case managers and other interprofessional care team colleagues.
• Provides mentorship and guidance to clinical teams and case management as needed on complex care and post-acute discharge.
• Monitors ongoing performance of initiatives, collects data, and develops recommendations/identifies opportunities for performance improvement.
• Analyzes trends in lengths of stay, census, readmissions, non-qualified hospital days, and the impact on continuum-based utilization using high-reliability frameworks.
• Coordinates efforts to optimize hospital days, including ineffective admission determinations, discharge planning, utilization of ancillary services, and timely placement.
• Monitors changes and stays current in evidence-based practices, healthcare regulations, payer requirements, accreditation standards, and industry standards to ensure appropriate changes are incorporated into patient care coordination.

Qualifications

• Education: Bachelor's Degree Nursing required and Master's Degree Nursing preferred
• Can this role accept experience in lieu of a degree? No
• Licenses and Credentials:
  • current RN registration in Massachusetts
  • Accredited Case Manager - Registered Nurse [ACM-RN] - American Case Management Association (ACMA) preferred
  • Accredited Case Manager [ACM] - American Case Management Association (ACMA) preferred
  • Case Management Administrator-Certified [CMAC] - The Center for Case Management preferred
  • Nursing Case Management [CMGT-BC] - American Nurses Credentialing Center (ANCC) preferred
• Experience:
  • Inpatient case management experience with advanced knowledge around standards of practice and regulatory and payer compliance 5-7 years required
  • Extensive experience and knowledge in discharge planning 5-7 years required
  • Extensive understanding of post-acute resources 5-7 years required
  • Utilization review 5-7 years preferred
• Knowledge, Skills and Abilities:
  • Case Management in acute setting and Utilization Management experience/knowledge.
  • Strong assessment and problem-solving skills.
  • Strong interpersonal skills.
  • Ability to work independently with minimal supervision.
  • Goal-oriented and accountable.
  • Demonstrated organizational skills.
  • Demonstrated ability to work in a complex setting.
  • Ability to work in an interdisciplinary team-based environment.
  • Strong oral and written communication skills.
  • Capacity and willingness to present cases/themes to internal and external stakeholders.
  • Computer experience preferred.

Additional Job Details (if applicable)

• Shift: 40hr day
• Remote Type
• Hybrid
• Work Location
• 45 Francis Street
• Scheduled Weekly Hours
• 40
• Employee Type
• Regular
• Work Shift
• Day (United States of America)