RN Case Manager (40hr)

Beth Israel Lahey Health; Needham (MA); On-site; USD 78,000 - 112,000; Full time

Job summary

Beth Israel Lahey Health is seeking an RN Case Manager to coordinate care for patients across medical, surgical, ICU, and outpatient settings. The role emphasizes discharge planning, utilization review, and collaboration with physicians and nurses to ensure appropriate levels of care.

The position requires nursing licensure and 3–5 years of acute or managed care experience, with knowledge of Interqual criteria and computer systems. Flexible hours and a rotating weekend/holiday schedule apply.

Qualifications

• Associate's degree in Nursing required; Bachelor's degree preferred.
• RN license required.
• 3–5 years related work experience in acute care or managed care with two years in case management.
• Knowledge of discharge planning and utilization review practices including Interqual criteria.
• Experience with computer systems including web-based applications and Microsoft Office.

Responsibilities

• Perform utilization management, care coordination, and discharge planning for assigned caseload.
• Coordinate and review medical records for severity of illness and intensity of service using Interqual criteria.
• Create case management care plans using assessment, planning, implementation, and evaluation processes.
• Facilitate multidisciplinary collaboration daily.

Skills

Discharge planning

Care coordination

Interqual knowledge

Communication

Teamwork

Problem solving

Education

Associate's degree in Nursing

Bachelor's degree in Nursing

Tools

Outlook

Word

Excel

PowerPoint

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.

40 hours per week; 9:00am-5:30pm or 9:30am-6:00pm; Rotate Every Third Weekend & Holidays

Job Description

Job Summary:

The RN Case Manager (CM) facilitates the coordination of care for those patients admitted to medical, surgical services, ICU, and as needed for outpatient areas including but not limited to the Emergency Department, PACU and Preadmission testing. The case manager consults and collaborates in activities related to the establishment of appropriate levels of care. He/She reviews patient's medical records and participates in direct and indirect communication with care givers to ensure continued appropriate level of acre, including the level of care of elective surgical cases. The case manager provides ongoing education to the physicians and nurses about levels of care. The RN Case manager, performs, consults, and collaborates in activities related to the development of safe effective and efficient discharge or disposition of patients for an assigned patient caseload. This role is patient-focused, outcome-oriented and based on professional nursing practice guidelines and the Standards of Practice for Case Management. And functions within a multidisciplinary practice model.

Essential Responsibilities

• Performs utilization management, care coordination, and discharge planning for assigned patient caseload.
• Coordinates and organizes a timely and accurate review of each medical record for severity of illness and intensity of service, utilizing Interqual criteria, to satisfy state and federal regulations by t reviewing and, investigating patient history, presenting symptoms, clinical status and treatment.
• Utilizes the case management process of assessment, planning, implementation and evaluation to create case management care plans for assigned patients.
• Facilitates multidisciplinary collaboration on a daily basis.

Required Qualifications:

• Associate's degree in Nursing required. Bachelor's degree in Nursing preferred.
• License Registered Nurse required.
• 3-5 years related work experience required in Acute care or managed care setting with two years prior experience in case management.
• Knowledge of discharge planning practices, understanding of utilization review practices including third party payer and insurance plans and acute hospital Interqual, criteria, current knowledge of federal, state, and regulatory requirements guiding case management practice.
• Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.

Competencies:

• Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.
• Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
• 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 collaborative teams for larger projects or groups both internal and external to the Medical Center and across functional areas. Results have implications for the management and operations of multiple areas 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, Youth: 6 months to 16 years, Young adult: 16-30 years, Middle Age: 30 - 60 years, Elderly: 60 -.

Physical Nature Of The Job

Light work: Exerting up to 20 pounds of force frequently to move objects. Some elements of the job are sedentary, but the employee will be required to stand for periods of time or move through out the hospital campus

Pay Range

$37.08 - $92.84

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.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. 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