Case Manager (RN), 40hrs

Location: Winchester, MA
Job ID: 176352-1A
Date Posted: May 19, 2022
Category: Nursing

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Job Description

Welcome To

Welcome to Winchester Hospital, part of Beth Israel Lahey Health. Winchester Hospital was the first hospital in Massachusetts to earn Magnet recognition, the American Nurses Association’s highest honor for nursing excellence, three times. It has since received the recognition a fourth time. As the northwest suburban Boston area’s leading provider of comprehensive health care services, the 229-bed facility provides care in general, bariatric and vascular surgery, orthopedics, pediatrics, cardiology, pulmonary medicine, oncology, gastroenterology, rehabilitation, radiation oncology, pain management, obstetrics/gynecology and a Level IIB Special Care Nursery.

 

About the Job

QUALIFICATIONS

Education Required:

  • Hired Prior to 10/1/13:  Graduate of a state approved and/or accredited RN program.
  • Hired On or After 10/1/13:  Bachelors’ degree in Nursing (BSN) or obtain BSN within 5 years of hire

Education Preferred:

  • BSN upon hire

 

Experience Required

  • At least five (5) years of clinical experience as a Registered Nurse
    Experience Preferred
  • Previous Case Management experience
     
     
    LICENSES, REGISTRATIONS, CERTIFICATIONS 

Required

  • Current license to practice professional nursing from MA Board of Registration

Preferred

  • Case Management certification

 

 

JOB FUNCTIONS

  • Maintains agility in the case management role as the needs of the hospital may continually evolve as the healthcare landscape changes resulting in changes to the case management model of care delivery.  Priority to any specific case management function may be amplified either temporarily or permanently for individual case managers based on the needs of the department, patients, and organization.  The department organizational chart is always subject to change based to ensure a high quality, high integrity, and high efficiency department..
  • Utilizes the case management process to provide quality and safe patient care by identifying the specific needs of the patient and developing the plan of care for discharge with the patient.
  • Establishes a therapeutic relationship with the patient, the patient's family and significant others by involving them in each step of the care coordination process and accommodates factors that may influence the plan of discharge.
  • Collaborates with the multi-disciplinary healthcare team regarding the patient’s plan of care to promote the best possible outcomes and patient/family experience upon discharge.
  • Addresses the patient’s physical, emotional, cultural, and spiritual needs.
  • Performs all required documentation accurately, legibly and timely.
  • Appropriately follows the chain of command and adheres to hospital policies and procedures.
  • Greets patients.  Rounds on patients daily to educate and inform them of their plan of care.
  • To assess the daily case management workflow and optimize the team’s efficiency, gathers census information, reviews admissions, reconciles admissions, transfers and discharges against census and conducts hand-offs regarding patients when appropriate.
  • Reviews discharges to verify the required insurance approvals have been received.
  • Collaborates with the patient, patient’s family, insurance companies and the multi-disciplinary team to determine and coordinate the patient’s next level of care.
  • Patient care rounds with multi-disciplinary team to review the plan of care.
  • Reviews patient’s charts, conducts utilization reviews, ensures the physician’s order is appropriate for the level of care the patient meets, applies InterQual criteria to determine the level of care, medical necessity, and coverage of hospitalization.

Shift

Hours: Fulltime; 40 hours

About Us

Beth Israel Lahey Health is dedicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve.  Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health.  Beth Israel Lahey Health Performance Network is a unified joint contracting and population health management organization, jointly governed by participating physicians and hospitals.

Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.