RN Care Manager, Emergency Department, 40 Hours (Days/Evenings)

JOB REQUIREMENTS

EDUCATION:

ADN required, BSN preferred

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

Licensed to practice as a Registered Nurse in the Commonwealth of Massachusetts

CCM or related certification attained within 24 months from the hire date is preferred

EXPERIENCE:

3-5 years of diversified clinical experience, including care management is required

ED experience preferred

A minimum of 2 years of previous experience involving judgment and decision making, preferably in a utilization management/case management position

KNOWLEDGE AND SKILLS:

• Extensive background and knowledge of current medical/surgical patterns of practice.

• Medical terminology and standard medical abbreviations.

• Managed care concepts, the various health care delivery systems

• Methods for assessing an individual are level of physical/mental impairment, understanding of the physical and psychological characteristics of illness, and understanding of expected treatment.

• Confidentiality issues and the legal and ethical issues pertaining to them.

• ICD-9 and CPT nomenclature and the ability to interpret and convert this information, as applicable.

• Knowledge of benefits and various plan contracts, eligibility issues and requirements.

• Role and functional responsibilities of case management professional; case management program philosophy and purpose within Managed Care Program

• Excellent interpersonal, verbal and written communication and negotiations skills

• Strong analytical, data management and PC skills