Baystate Health System

RN Hospital Case Manager

Baystate Health System$98K — $133K *
Hospitals & Medical Centers
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • BSN Required
  • 5 years clinical Nursing experience
  • Hospital Case Management or Care Coordination experience preferred
  • Familiarity with community resources and third-party payer standards
  • Excellent interpersonal and organizational skills

Responsibilities

  • Facilitates care plans as part of the overall patient care
  • Leads daily huddles with nursing staff to monitor patient progress
  • Works with healthcare teams to optimize hospital resource use
  • Evaluates appropriateness of patient admissions using evidence-based criteria
  • Communicates with payers to manage patient outcomes
  • Engages with physicians to formulate safe transitional care plans
  • Directs care transitions to appropriate settings
  • Conducts assessments to prevent patient readmissions
  • Handles concurrent denials to secure appropriate reimbursements

Benefits

  • Comprehensive medical, dental, and vision insurance
  • 403b retirement plan with company match
  • Certification and continuing education reimbursement
  • Wellbeing reimbursement for activities like gym memberships
  • Access to free money coaching services
  • Life insurance coverage
  • Pet, home, auto, and personal insurance options
Full Job Description
RN Case Manager

Full Time - 40 Hours

The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that will ensure continuity and effective community or post acute reentry. The Hospital Case Manager leads the interdisciplinary team in developing complex discharge plans.

Responsibilities:
  • Facilitates patients care plan as called for in the plan of care
  • Leads daily patient care huddles with nursing to direct timely progress along the continuum
  • Works cooperatively as a leading member of the health care team to insure appropriate use of hospital resources, patient satisfaction, and achievement of quality of care. Manages input from all health care professionals and conducts assessments to determine patients health care and transitional needs. Su
  • Evaluates and ensures appropriateness of admissions and continued stay using evidence based criteria
  • Collaborates and manages outcomes with the payers through ongoing written and verbal communications to appropriate parties
  • Leads discussions with Physician advisors and MD's about safe plan for transitions
  • Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate
  • Collaborates with community case managers and other health care advisors to ensure a smooth and safe continuum of care plan
  • Conducts extensive assessments and implements interventions for patients at risk for readmissions
  • Manages concurrent denials and works with physicians to overturn for appropriate reimbursement


Required Work Experience:
  • BSN Required
  • 5 years clinical Nursing experience
  • Hospital Case Management, Care Coordination experience strongly preferred


Skills and Competencies:
  • Requires a working knowledge of community resources and Utilization/Quality Review standards and activities conducted by third party payers
  • Ability to organize and prioritize workload in order to meet deadlines
  • Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third party payers where appropriate
  • Excellent computer skills
  • Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third party payers where appropriate
  • There is a weekend and holiday commitment.


THE ADVANTAGES OF WORKING WITH BAYSTATE!
  • Excellent Compensation
  • High-quality, low-cost medical, dental and vision insurance
  • Pet, home, auto and personal insurance
  • Certification and continuing education reimbursement
  • 403b retirement company match & annual company contribution increase based on years of service
  • Life insurance
  • Free money coach advice from a certified professional
  • Reimbursement for a variety of wellbeing activities, included but limited to: gym membership and equipment, personal trainer, massage and so much more!
  • Wellbeing programs that include but are not limited to mental, physical, and financial health


Our Compensation Philosophy

We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above considers the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role.

Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.

Minimum - Midpoint - Maximum
$98,051.00 - $112,715.00 - $133,348.00

About Baystate Health System

Baystate Health is a not-for-profit, integrated health care system serving over 800,000 people throughout western New England. The system includes five hospitals, a large network of primary care and specialty care providers, and a range of community-based health services. Baystate Health is the largest employer in western Massachusetts, with over 12,000 employees, and is a major contributor to the region's economy. The system is committed to providing high-quality, affordable health care to all patients, regardless of their ability to pay, and has received numerous awards and recognitions for its clinical excellence and patient-centered care.
Learn more about Baystate Health System
Size
12,000 employees
Industry
Founded
1883

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