Full Time

Inpatient Unit - 40 hours - E/O Weekend & Holiday

Emergency Department - 36 hours -E/O Weekend & Holiday

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:

• Current Massachusetts Registered Nurse (RN) license
• BSN preferred
• 3-5 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.

Benefits That Support You

At Baystate Health, you get the best of both worlds: the resources, stability, and career opportunities of a large integrated healthcare system with the supportive culture of a community-focused organization.

Depending on eligibility, benefits may include:

• Competitive Pay & Benefits: Medical, dental, and vision coverage, including local Health New England plans.
• Tuition & Training: Tuitionassistance, CEUs, and professional development opportunities.
• Career Growth: Clinical advancement, leadership development, and internal career opportunities.
• Regional Opportunities: Career options across Baystate Health hospitals, practices, and services throughout western Massachusetts.
• Retirement: Retirement savings and employer match.
• Paid Time Off: Generous PTO for eligible employees.

Whether you provide direct patient care, clinical services, or operational support, your work at Baystate Health helps improve the health of the communities we serve.

Education:

Certifications:

Compensation

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