Department: Case Management
Location: Cambridge Hospital, Cambridge, MA
Employment Type: Full Time
Job Type: Union
Union Name: TCH MNA-TCH Mass Nurses Assoc
Work Shift: Days
Work Days: 8 am - 4:30 pm
Date Posted: Dec-19-16
Requisition Number: hrq-71255
The Case Management Nursing staff provides care with an emphasis on culturally sensitive, evidence based nursing practice. This dynamic role of the RN Case Manager in the Emergency Department is to assist the Emergency Department in effective throughput and workflow. Responsibilities include screening patients for medical necessity, level of care and admission status. Will contact insurance companies to assess coverage and the need for authorization for admission and post discharge care when indicated. Will be responsible for readmission reduction strategies and will review patient information for clinical documentation of level of care, compliant with CMS requirements related to the IPPS Rule. In this role they will provide real time Utilization Review and Discharge Planning. In addition this position requires the strong ability to work effectively with patients with substance abuse and behavioral health conditions requiring assistance across the continuum of care.
· RN Required
· The case manager role is structured around 3 major functions: care coordination, utilization management and discharge planning. Each of these functions supports the CM department goals: improved patient satisfaction and patient outcomes, decreased length of stay and decrease unit cost. The case manager provides case management resources to the inpatient CM program on both medical-surgical and psychiatric units.
Current MA RN licensure. BSN is required of external candidates. AHA BLS required at the time of hire
Certification in Case Management preferred RN with 3 to 5 years previous acute care clinical experience required. Previous experience as an Acute Case Manager preferred 3 years experience in case management/utilization review, discharge planning, or home health care management preferred
Computer proficiency, excellent oral and written communication skills, and demonstrated negotiation skills are needed.
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