Case Manager
 Spaulding Nursing & Therapy Centers | |
 United States, Massachusetts, Boston | |
| 100 North Beacon Street (Show on map) | |
 Jan 16, 2025 | |
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Summary
Serves as core member of care team, coordinates and supports healthcare within the facility and coordinates referrals for services outside the clinic. Provides outreach and enrollment services to meet eligibility requirements of program and surrounding counties. Ensures coordination and planning with the inclusion of community and family support. Focuses on the development and coordination of community service plans. Partners with service providers, families, and patient to create plan of healthcare and identifies additional service providers. Does this position require Patient Care? Yes Essential Functions -Client Assessments and Planning -Modify patient treatment plans as indicated by patients' responses and conditions. -Prepare patient/family for discharge -Communicates with third party payers to obtain necessary authorization for reimbursement of services. -Review cases with medical directors on challenging cases as needed -Defines care goals of patients by providing education, information, and direction to each individual and family. -Maintain accurate, detailed reports and records. -Communicates with third party payers to obtain necessary authorization for reimbursement of services. Education Associate's Degree Nursing required or Bachelor's Degree Nursing preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Registered Nurse [RN - State License] - Generic - HR Only required Basic Life Support [BLS Certification] - Data Conversion - Various Issuers preferred Experience case management, utilization review, or discharge planning experience 2-3 years preferred Knowledge, Skills and Abilities - Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times. - Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems. - Ability to establish strong rapport and relationships with patients and staff. - Proficient in Microsoft Office and industry related software programs. - Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions. - Ability to maintain client and staff confidentiality. - Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care. - Knowledge of Healthcare and Managed Care preferred. Physical Requirements Spaulding Nursing and Therapy Center Brighton, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. | |