Position Summary:

The Case Manager is responsible and accountable for the management of care for an assigned patient population by service line and across the continuum of care. The Case Manager, works to achieve daily clinical, quality, and cost outcomes by providing well-coordinated experiences for patients/families through the synchronization of care activities of multiple disciplines and negotiation with third-party payers. Demonstrate great assessment skills and knowledge to accurately develop and implement a comprehensive care plan specific to the identified need/s. Coordinate all aspects of the patient's care plan including by not limited to home health care/hospice referrals, home infusion services, DME, transportation, etc. Facilitate communication and coordination among members of the interdisciplinary team. Involve the patient in the decision-making process in order to minimize fragmentation in the services provided. Communicate the patient's preferences, serving as their advocate and verifying that interventions meet their individualized needs and goals of treatment. Provide information about resources and options available in the community and coordinate service delivery. Identify and address client risk factors and/ or obstacles to care Educates the patients and families regarding various symptoms and consequences related to their specific diseases, conditions and treatment.

Hours:

40 hours/week, Day Shift Flexible hours, either: 8-4:30, 8:30-5, or 9-5:30

Education and Qualifications:

Massachusetts RN Licensure. Current Basic Life Support (BLS) Certification. Bachelor of Science in Nursing (BSN) preferred ASN required Recent experience as an inpatient case manager 3 years + case management experience

What We Offer:

Competitive salaries & benefits that start on day one 403(b) retirement plan with company match Tuition reimbursement Free parking Job Profile Summary This role focuses on providing professional and nonprofessional nursing care services in accordance with physician orders. In addition, this role focuses on performing the following Care Manager related duties: Works as part of a multidisciplinary team to coordinate their patient's care in an effort to improve patient outcomes and create efficiencies. A professional individual contributor role that may direct the work of other lower level professionals or manage processes and programs. The majority of time is spent overseeing the design, implementation or delivery of processes, programs and policies using specialized knowledge and skills typically acquired through advanced education. A senior level role that requires advanced knowledge of job area typically obtained through advanced education and work experience.

Typically responsible for:

managing projects / processes, working independently with limited supervision, coaching and reviewing the work of lower level professionals, resolving difficult and sometimes complex problems. Job Overview The RN Case Manager manages a designated caseload to coordinate and complete timely assessment, planning, implementation and evaluation of discharge plans and care transitions across the continuum of care.

Duties and Responsibilities:

The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned. 1. Interviews and collects specific information and data from patients and families, contributes to the identification of specific physical, emotional, educational and cultural needs of those patients. 2. Maintains documentation of assessment findings, discharge arrangements, and actions taken according to departmental guidelines. 4. Completes a discharge assessment, to include appropriate documentation, according to established policies and procedures. 5. Identifies barriers to efficient cost-effective provision of care. 6. Identifies expected outcomes individualized to the patient. Collaborates with physician, healthcare team, and the patient/family in decision making and planning of care during hospitalization and in anticipation of discharge. 7. Implements the plan of care to achieve the identified expected outcomes for the patient. 8. Utilizes community and other resources and systems to implement the plan facilitating referrals when appropriate. 9. Provides education for the patients and families and documents according to policy. 10. Coordinates activities related to financial/insurance issues, including providing clinical updates to insurance companies. 11. Coordinates insurance appeals related to discharges and adhering to policies and procedures of Medicare and Medicaid. 12. Assists in achieving unit quality scores which meet or exceed hospital established targets for nurse sensitive quality indicators as appropriate for the unit.

Physical Requirements:

1. Ability to sit for extended periods of time. 2. Prolonged standing and walking. 3. Occasional twisting, bending, reaching, pushing/pulling, sitting, kneeling, and squatting.

Skills & Abilities:

1. Ability to plan, implement and evaluate data and individual patient needs after emergency department visits. 2. Ability to effectively communicate with patients, families, physicians, and healthcare team. Ability to analyze, evaluate multiple solutions, and solve complex problems using well developed critical & analytical thinking skills. 3. Knowledge of and application of the nursing process. 4. Excellent time management skills needed to prioritize competing priorities. 5. Requires the ability to work independently and establish an effective working relationship with healthcare providers in physician's offices, community agencies, hospitals and other healthcare facilities. 6. Maintains working knowledge of specific benefits and reimbursement guidelines, the discharge planning process and applicable federal, state and local regulations.

About MelroseWakefield Hospital:

MelroseWakefield Hospital and Lawrence Memorial Hospital of Medford are two campuses with one community in mind: the people of north suburban Boston. MelroseWakefield Hospital and Lawrence Memorial Hospital are distinguished by the range of high-quality clinical care and services. Our teams welcome everyone with hospitality and humanity. We focus on reducing health disparities through 40+ local health programs across a system of hospitals, urgent care locations, outpatient services, and community physicians. Core to our values, MelroseWakefield Healthcare's commitment to community is demonstrated by our many local health programs throughout our service area and participation in partnerships with community agencies and events, and education programs in more than 10 communities to support the wellness and health of our residents. About Tufts Medicine A healthcare system that works Tufts Medicine is more than a health system — we're a community that empowers people to live their best lives by reimagining healthcare, advancing knowledge and pioneering discovery. Every team member plays an integral role in realizing our vision of creating the most equitable and frictionless healthcare experience in the world. Here, you'll join an enthusiastic community that champions your growth and receive generous benefits to support you and your family's well-being. Tufts Medicine is an equal opportunity employer. At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day. The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals. Beyond base pay, Tufts Medicine provides a comprehensive Total Rewards package that supports your health, financial security, and career growth—one of the many ways we invest in you so you can thrive both at work and outside of it.

Pay Range :

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