Registered Nurse, Care Management
Utilizing a collaborative process, the care manager will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual’s health needs, using communication and available resources to promote quality, cost-effective outcomes. The care manager helps identify appropriate providers and facilities throughout the continuum of services while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the patient and the reimbursement source. This care manager is dedicated to handle the increased volume and to support the overall care management process and the department.
Position: RN Float Nurse Case Manager
DEPARTMENT: Case Management
SCHEDULE: All Shifts
JOB REQUIREMENTS
EDUCATION:
Graduate of an accredited ASN/BSN Program in Nursing. Ability to receive BSN within 4 years of hire date.
CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED :
· Licensed to practice as a Registered Nurse in the commonwealth of Massachusetts
· CCM or related certification attained within 24 months from the hire date is preferred
EXPERIENCE:
· 3-5 years of diversified clinical experience is required
· A minimum of 2 years of previous experience involving judgment and decision making, preferably in a utilization management/case management position
KNOWLEDGE AND SKILLS:
· Extensive background and knowledge of current medical/surgical patterns of practice.
· Medical terminology and standard medical abbreviations.
· Managed care concepts, the various health care delivery systems
· Methods for assessing an individual are level of physical/mental impairment, understanding of the physical and psychological characteristics of illness, and understanding of expected treatment.
· Confidentiality issues and the legal and ethical issues pertaining to them.
· ICD-9 and CPT nomenclature and the ability to interpret and convert this information, as applicable.
· Knowledge of benefits and various plan contracts, eligibility issues and requirements.
· Role and functional responsibilities of case management professional; case management program philosophy and purpose within Managed Care Program
· Excellent interpersonal, verbal and written communication and negotiations skills
· Strong analytical, data management and PC skills
This requisition remains open on a continuous basis until all positions are filled, or the requisition is formally closed. Applicants may be considered at any time throughout this period. Please be advised that due to the ongoing nature of this recruitment process, we may be unable to provide individualized updates regarding the status of your application.
Equal Opportunity Employer/Disabled/Veterans
According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.
Recommended Jobs
Principal AI/ML Engineer
Job Description Job Description Location: Cambridge, MA (Eastern Time / UTC -4) Relocation package available Start date: ASAP Languages: English (required) About the Role Pragmatik…
Mental Health Clinician, Part time
Job Description Job Description Sparks Counseling Services, LLC is currently seeking an experienced clinician that is determined to influence mental health outcomes within the community. Seeking …
Registered Nurse - RN
Explore opportunities with Caretenders, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are …
Production Manager - Food & Beverage | Lean & Continuous Improvement
Our client is seeking a Production Manager to oversee all manufacturing operations within a high‑volume food and beverage production environment. This leader is responsible for meeting safety, qual…
Landscape Design Sales Specialist
Landscaping by J. Michael is looking for a Landscape Designer/Estimator to join our Marshfield office. The ideal candidate is a resourceful self-starter who is not only a team player, but also cap…
Travel Registered Nurse Postpartum Job
Job Overview Employer: TLC Nursing Associates, Inc. Responsibilities TLC Nursing Associates, Inc. is seeking a Travel RN – Postpartum to provide compassionate and specialized care to moth…
Retail Sales - Accessories - Natick Mall
Retail Sales - Accessories - Natick Mall at Nordstrom summary: CVWalletExtranet.Domain.Entities.JobShortDescription Are you passionate about fashion, styling, and helping people look and feel t…
Commissioning Field Engineer II
FST Technical Services’ Commissioning (Cx) Division is recognized as one of the leading commissioning firms in the nation. We partner with clients to provide comprehensive quality assurance througho…
Endoscopy Technician- Mooresville & Randolph Road Office
LOCATION: Mooresville & Randolph Road SUPERVISION RECEIVED:Reports to Endoscopy Manager EDUCATION:High school graduate with additional technical training in the medical field such as CMA, NA, etc. …
Hepato-Pancreato-Biliary Surgeon
Hepato-Pancreato-Biliary Surgeon Department of Surgery St. Elizabeth’s Medical Center Boston Medical Center Health System, Boston, MA The Department of Surgery, Division of General Surg…