RN Care Manager: Care Coordination & Discharge Lead

bmc; Boston (MA); On-site; USD 90,000 - 120,000; Full time

Job summary

BMC in Boston is seeking an RN Care Manager to assess, plan, implement, monitor, and evaluate care for a designated patient caseload. You will identify providers and coordinate resources across the continuum to promote high-quality, cost-effective outcomes.

The role emphasizes collaboration with physicians and care teams to ensure timely discharge, comprehensive documentation, and adherence to utilization and quality standards in a busy hospital setting.

Responsibilities

• Conduct a thorough and objective evaluation of the client's current status including physical, psychosocial, environmental, financial, and health status.
• Collaborates with physicians, nursing, and multidisciplinary care team to ensure timely patient management.
• Ensures appropriate clinical pathway assignment by staff nurses.
• Addresses/resolves system problems impeding diagnostic or treatment progress.
• Proactively identifies and resolves delays and obstacles to discharge.
• Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge.
• Collaborates with the physician and all members of the multidisciplinary team to monitor the patient's progress and ensure that the plan of care and services provided are patient-focused, high quality, efficient, and cost effective; facilitates completion and reporting of diagnostic testing, treatment plan, discharge plan, and documentation.
• Maintains communication with medical staff to eliminate barriers to efficient delivery of care; completes utilization management and quality screening for assigned patients.
• Applies approved utilization acuity criteria to monitor admisssions and continued stays and documents findings.
• Monitors length of stay and ancillary resource use; takes actions to improve both areas.
• Assesses resource utilization and cost management; diagnoses, treatment, prognosis, goals.
• Refers cases to physician advisor and follows up as indicated.
• Communicates with resource center to facilitate covered day reimbursement certification; discusses payer criteria with clinical staff and resolves payer issues.

Job description

BMC in Boston is seeking an RN Care Manager to assess, plan, implement, monitor, and evaluate care for a designated patient caseload. You will identify providers and coordinate resources across the continuum to promote high-quality, cost-effective outcomes.

The role emphasizes collaboration with physicians and care teams to ensure timely discharge, comprehensive documentation, and adherence to utilization and quality standards in a busy hospital setting.