RN Case Manager, Part Time

Baystate Health; Springfield, Northern (MA, KY); Hybrid; USD 98,000 - 133,000; Full time

Benefits offered by this job

High-quality health insurance

Dental and vision insurance

Certification and continuing education

403b retirement plan

Life insurance

Wellbeing programs

Wellbeing activities reimbursement

Job summary

Baystate Health is seeking a Hospital Case Manager to coordinate clinical care, quality and financial outcomes for a defined patient population, guiding an interdisciplinary team to develop complex discharge plans and ensure safe transitions.

The role requires strong nursing expertise, with BSN preferred and 3–5 years of clinical experience, emphasis on care coordination, utilization review, and collaboration with payers to optimize outcomes.

Qualifications

• BSN preferred
• 3-5 years clinical nursing experience
• Hospital case management and care coordination experience preferred

Responsibilities

• Facilitates patients care plan as called for in the plan of care
• Leads daily patient care huddles with nursing to direct timely progress along the continuum
• Works cooperatively as a leading member of the health care team to insure appropriate use of hospital resources, patient satisfaction, and achievement of quality of care
• Evaluates and ensures appropriateness of admissions and continued stay using evidence-based criteria
• Collaborates and manages outcomes with the payers through ongoing written and verbal communications to appropriate parties
• Leads discussions with Physician advisors and MD's about safe plan for transitions
• Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate
• Collaborates with community case managers and other health care advisors to ensure a smooth and safe continuum of care plan
• Conducts extensive assessments and implements interventions for patients at risk for readmissions
• Manages concurrent denials and works with physicians to overturn for appropriate reimbursement

Skills

Community resources

Utilization review

Prioritization

Interpersonal skills

Weekend availability

Education

Associates Degree in Nursing (Required)

Bachelors Degree in Nursing

Case Management Certification

RN – Massachusetts

Job description

The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that will ensure continuity and effective community or post-acute reentry. The Hospital Case Manager leads the interdisciplinary team in developing complex discharge plans.

Responsibilities:

• Facilitates patients care plan as called for in the plan of care
• Leads daily patient care huddles with nursing to direct timely progress along the continuum
• Works cooperatively as a leading member of the health care team to insure appropriate use of hospital resources, patient satisfaction, and achievement of quality of care. Manages input from all health care professionals and conducts assessments to determine patients health care and transitional needs. Su
• Evaluates and ensures appropriateness of admissions and continued stay using evidence-based criteria
• Collaborates and manages outcomes with the payers through ongoing written and verbal communications to appropriate parties
• Leads discussions with Physician advisors and MD's about safe plan for transitions
• Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate
• Collaborates with community case managers and other health care advisors to ensure a smooth and safe continuum of care plan
• Conducts extensive assessments and implements interventions for patients at risk for readmissions
• Manages concurrent denials and works with physicians to overturn for appropriate reimbursement

Required Work Experience:

• BSN Preferred
• 3-5 years clinical Nursing experience
• Hospital Case Management, Care Coordination experience strongly preferred

Skills and Competencies:

• Requires a working knowledge of community resources and Utilization/Quality Review standards and activities conducted by third party payers
• Ability to organize and prioritize workload to meet deadlines
• Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third-party payers where appropriate
• Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third-party payers where appropriate
• There is a weekend and holiday commitment.

THE ADVANTAGES OF WORKING WITH BAYSTATE!

• High-quality, low-cost medical, dental and vision insurance
• Pet, home, auto and personal insurance
• Certification and continuing education reimbursement
• 403b retirement company match & annual company contribution increase based on years of service
• Life insurance
• Free money coach advice from a certified professional
• Reimbursement for a variety of well-being activities, included but limited to gym membership and equipment, personal trainer, massage and so much more!
• Wellbeing programs that include but are not limited to mental, physical, and financial health

Our Compensation Philosophy

We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above considers the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role.

Education:

Associates Degree in Nursing (Required), Bachelors Degree in Nursing

Certifications:

Case Management Certification – OtherOtherOther, Registered Nurse – State of MassachusettsState of MassachusettsState of Massachusetts

Compensation

Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.

Minimum – Midpoint – Maximum

$98,051.00 – $112,715.00 – $133,348.00

Equal Employment Opportunity Employer