Address
Form of workWhen you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
Job Type:
RegularScheduled Hours:
40Work Shift:
Day (United States of America)Case Manager RNJob Description:
Case Manager RN
Position Summary: Beverly/Addison hospital uses a Triad Model for Care Coordination. The triad model adds a third staff member to the team with responsibilities assigned as follows:
- A nurse who performs coordination of care, discharge planning, transition planning
- A SW who provides psychosocial assessments and assistance with high-risk discharges
- A nurse who performs utilization review by application of Medical Necessity Guidelines currently Change Healthcare’s InterQual for commercial products and Medicare patients application of CMS 2 Midnight Rule.
Case managers serve as the care coordinators for patients, caregivers, and families. Their functions include understanding the patients’ needs and correlating how those needs can be met both logistically and financially, which is often dependent on the level of care of the patient. The CM RN who performs discharge planning shall provide options to patients/caregivers while clearly understanding the payer source for those services. They coordinate safe discharge plans between the health care delivery team, patients, families, insurers and continuing care agencies while adhering to patients’ rights. Case manager nurses and Utilization review nurses communicate and collaborate to ensure that the patient is in the accurate level of care.
Education/Experience:
1. Registered Nurse - BSN and CCM preferred
2. Excellent clinical skills in acute hospital setting
3. Knowledge of Utilization Management and how it directs the discharge plan. 4. Excellent communication/interpersonal skills
Certification/Licensure:
Registered nurse required.
BSN preferred CCM preferred
Patient Age Served: Provides indirect/supportive care to: Neonates, Adult, Pediatric, Geriatric Adolescent
FLSA Status:
ExemptAs 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) and COVID-19 as a condition of employment. Learn more about this requirement.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
