RN, Case Manager/Continuing Care Coordinator

Duties/Responsibilities:

• Identifies continuing care needs through assessment, interdisciplinary care rounds and/or requests.
• In collaboration with patients, families and community services establishes a coordinated discharge plan based on the patient's transition needs.
• Coordinates continuing care services to include skilled nursing, durable medical equipment and community services.
• Interfaces with aftercare providers to ensure smooth transition with the post discharge plan of care.
• Conducts ongoing assessment to determine the continued need for acute care, and appropriateness/timeliness of treatments/procedures to optimize reimbursement.
• Collaborates with the UR team regarding level of care determination/LOS.
• Coordinates continuing care for SDC, ED and other outpatient areas on request.

It is understood that this is a summary of key job functions and does not include every detail of the job that may reasonably be required.

Education/Experience Required:

• Current MA RN License
• Bachelor's Degree in Nursing or advanced degree in healthcare preferred.
• CCM certification preferred.
• A minimum of 1 year case management experience working independently in an acute or post-acute setting or a minimum of 1 year experience independently coordinating transitions of care in the healthcare setting with knowledge of community resources.
• Ability to identify appropriateness of patients admission and level of care needs (inpatient and observation) utilizing Interqual criteria.
• Knowledge of Interqual and Allscripts systems preferred.
• Strong interpersonal and negotiations skills demonstrated by a positive attitude, pleasant, professional and cooperative demeanor with patients, physicians, fellow employees, and insurance companies.
• Computer skills, including Microsoft Outlook, Word, Excel and Meditech.
• Ability to work independently.

Registration/Certification:

• Massachusetts RN License.