Care Management Manager

At Boston Medical Center-Brighton our nurses are changing the face of healthcare. At every level and on every unit, BMC Brighton nurses are advancing professional practice and delivering evidence-based care to our patients, families, and community. Boston Medical Center Health Systems is one of the top places to work in health care, we know that providing exceptional care for patients begins with caring for our staff. That’s why you’ll find a supportive work environment at BMC Brighton with rich opportunities throughout your career for training, development, and growth and where you’ll have the tools you need to take charge of your own practice environment. There’s never been a better or more exciting time to become a BMC Brighton nurse.

POSITION SUMMARY:

Provides direct supervision for the Nurse Care Managers in the Case Management department. Accountable for hiring, scheduling, supervising and completing performance appraisal process of all nurse case management staff. Oversees the coordination of special projects and programs within the department including Utilization Review, Care Coordination, Discharge Planning and RN Continuing Education Program. Will also utilize nursing techniques and theory, to consult on, assess, and intervene with high-risk patients and their families regarding the impact/amelioration of medical and physical problems.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required)

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Provides direct supervision for the Nurse Care coordinators in the Case Management department.

• Accountable for hiring, scheduling, supervising and completing performance appraisal process of all nurse case management staff.

• Oversees the coordination of special projects and programs within the department including Utilization Review, Care Coordination, Discharge Planning and RN Continuing Education Program.

• Utilize nursing techniques and theory, to consult on, assess, and intervene with high-risk patients and their families regarding the impact/amelioration of medical and physical problems.

• Responsible for completing and submitting timecards to payroll for all direct reports.

• Develops daily and monthly schedule for direct reports.

• Performs other duties as assigned.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required)

JOB REQUIREMENTS :

• Requires BSN from an accredited school of Nursing.

• Licensed to practice professional nursing as a registered nurse in the Commonwealth of Massachusetts

• A total of 3-5 years of clinical experience, 1-3 years of which are required to be in an inpatient care management setting.

PREFERRED EDUCATION AND EXPERIENCE

• Master’s degree in nursing preferred

• 2 years of leadership experience preferred

• Experience working in a unionized environment preferred.

CERTIFICATIONS, LICENSES, REGISTRATIONS REQUIRED

• Massachusetts RN license that is current and active

• BLS certification required

• ACLS certification preferred.

KNOWLEDGE AND SKILLS:

• Ability to understand confidentiality and the legal and ethical issues pertaining to patient health; understand medical terminology, how to obtain an accurate history; establish treatment goals; establish working relationships with referral sources; develop treatment plans.

• Ability to understand methods for assessing an individual's level of physical/mental impairment; understand the physical and psychological characteristics of illness; be able to assist individuals with the development of short- and long-term health goals.

• Ability to understand the requirements for prior approval by payer; be able to evaluate the quality of necessary medical services; be able to acquire and analyze the cost of care; understand the various health care delivery systems and payer plan contracts; be able to demonstrate cost savings.

• Ability to understand case management philosophy and principles; apply problem solving techniques to the care management process; document care management services; understand liability issues for care management activities.

• Knowledgeable on how to access and evaluate the available resources to meet a client's needs; able to develop new resources.

• Strong analytical, data management and PC skills.

• Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.

• Understanding of pre-acute and post-acute venues of care and post-acute community resources.

• Ability to understand confidentiality and the legal and ethical issues pertaining to patient health; understand medical terminology, how to obtain an accurate history; establish treatment goals; establish working relationships with referral sources; develop treatment plans.

• Ability to understand methods for assessing an individual's level of physical/mental impairment; understand the physical and psychological characteristics of illness; be able to assist individuals with the development of short- and long-term health goals.

• Ability to understand the requirements for prior approval by payer; be able to evaluate the quality of necessary medical services; be able to acquire and analyze the cost of care; understand the various health care delivery systems and payer plan contracts; be able to demonstrate cost savings.

• Ability to understand case management philosophy and principles; apply problem solving techniques to the care management process; document care management services; understand liability issues for care management activities.

• Knowledgeable on how to access and evaluate the available resources to meet a client's needs; able to develop new resources.

• Excellent interpersonal, verbal, and written communication and negotiation skills Strong analytical, data management and PC skills.

• Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.

• Understanding of pre-acute and post-acute venues of care and post-acute community resources.

• Strong organizational and time management skills, as evidenced by a capacity to prioritize multiple tasks and role components.

• Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.

JOB BENEFITS:

• Competitive pay

• Staff self-scheduling

• Weekend shift differentials

• Highly subsidized medical, dental, and vision insurance options

• Nurse staffing plans that often exceed state standards for quality and safety

• Employee Referral Program for Registered Nurses up to $7500

• Supportive work environment with a focus on training, professional development, and growth

Equal Opportunity Employer/Disabled/Veterans

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