RN Case Manager - Inpatient Case Management

Cambridge Health Alliance; Everett (MA); On-site; USD 58,000 - 129,000; Full time

Job summary

Cambridge Health Alliance (CHA) is seeking an RN Case Manager for Inpatient Case Management in Everett, MA. You will provide clinically-based case management to support patient care aligned with regulatory requirements, under the supervision of the Director of Care Management.

The role emphasizes collaboration with care teams, ensuring medical necessity, and coordinating post-acute transitions to optimize outcomes and resource use.

Qualifications

• BSN preferred.
• Current MA RN License.
• AHA BLS certification is required.
• Certification in Case Management preferred.

Responsibilities

• Collaborate with health care team to identify resource utilization and ensure reimbursement.
• Utilize criteria to confirm medical necessity for admission and continued stay.
• Develop post-acute care plan with patient, family and care teams to transition from inpatient to post-acute care.

Education

MA RN License

BLS Certification

BSN preferred

Job description

Cambridge Health Alliance (CHA)'s Inpatient Case Management provides psychosocial assessments, evaluations, and referrals for adults, and/or families with psychiatric illness, substance abuse, and medical illness. Casework or therapy takes place in the hospital setting. Cross Training to all areas of Care Management

Under the general supervision of the Director of Care Management, the RN Case Manager provides clinically-based case management to support the delivery of effective and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation.

Key Responsibilities:

• Collaborate with other members of the health care team to identify appropriate utilization of resources and to ensure reimbursement.
• Utilize criteria to confirm medical necessity for admission and continued stay.
• With the patient, family and health care team, create a post-acute care plan appropriate to the patient's needs and resources and facilitate this transition in concert with that patient's inpatient and post-acute care teams.

Qualifications/Requirements:

• BSN preferred
• Current or Conditional MA RN License
• Current American Heart Association (AHA) for Healthcare Providers BLS (Basic Life Support) certification is required
• Certification in Case Management preferred

Pay Range: $42.00 - $94.90 per hour

Department: Inpatient Case Management Everett