RN Case Manager

BMC Software; Brockton (MA); On-site; USD 54,000 - 111,000; Part time

Job summary

BMCHS is seeking a Part Time RN Case Manager in Brockton, MA. The role focuses on ensuring appropriate levels of care and coordinating discharge planning with the Social Work team for medically complex cases.

You will collaborate with the SW Care Coordinators, participate in department education, and contribute to improving LOS and documentation practices. Requires RN licensure in Massachusetts and acute care experience.

Qualifications

• Nursing degree required: diploma, ASN or BSN (preferred); BSN within 4 years required.
• MA RN licensure required; Case Management certification preferred.
• Recent acute care or managed care case management experience.
• Strong computer skills and data analytics abilities; proficient in Word/Excel/PowerPoint.

Responsibilities

• Perform InterQual reviews and coordinate with insurers for authorization.
• Collaborate with Social Work Care Coordinators on discharge plans.
• Coordinate clinically difficult discharge plans with SW team.
• Review department performance reports (LOS, denials, documentation).
• Support Care Coordination Manager in educational needs and objectives.

Skills

Data analytics

Teamwork

MS Office

Education

Nursing degree (Diploma/ASN/BSN)

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Job description

Position: RN Case Manager

Location: BMC South - Brockton, MA

Schedule: Part Time, 32 hours, Every 4th Weekend

POSITION SUMMARY:

The RN Case Manager (CM) is an exempt position and is responsible for overseeing the appropriate level of care and collaborates with the Social Work partner regarding discharge planning with a particular focus on medically complex discharge planning. The RN CM will be assigned to selected areas of the Hospital based upon department staffing and coverage. The RN CM will collaborate with SW Care Coordinator as a team to meet the needs of the patients within unit assigned. As this is an evolving position, duties and responsibilities may vary based on specific assignments. Each staff member will participate in a departmental orientation focused on Case Management Standards of Practice. All staff will be cross-trained and oriented to the ED Case Management Practice.

ESSENTIAL RESPONSIBILITIES / DUTIES:

Scope of Authority:

• Perform InterQual reviews on assigned patients and working with insurers to provide clinical information, answer questions, obtain insurance authorization for patients.
• Collaborate with Social Worker (SW) Care Coordinators on the units who will be responsible for the development and execution of patient discharge plans.
• Coordinate with the SW Care Coordinators for clinically difficult discharge plans.
• Review reports on the Department’ s performance including but not limited to - LOS, clinical denials and appeal status, avoidable days, time of discharge, proper level of documentation.
• Work with Care Coordination Manager/Director to develop educational needs and identify strategies to accomplish objectives of the Department.

JOB REQUIREMENTS

• Education: Nursing degree required: diploma, ASN or BSN (preferred); Ability to obtain BSN within 4 years required
• Certifications/Licenses: MA RN licensure, Case Management certification preferred
• Experience: Recent experience in acute care setting involved with clinical activities and/or a managed care environment working in case management, recent experience in a case management role or related role
• Knowledge & Skills: Excellent computer skills including managing work against performance metrics and reporting on key indicators important to the department. Strong computer skills with knowledge and proficiency with Microsoft Word, Excel and PowerPoint. Demonstrate data analytic skills. Demonstrated skills in working collaboratively with physicians, managers and other team members. Demonstrated skills in organizing and facilitating interdisciplinary teams to ensure timely discharge. Evidence of continued professional development

Compensation Range:

$38.86- $80.77

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Equal Opportunity Employer/Disabled/Veterans