Nurse Case Manager, 40 hours, Days

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Nurse Case Management is a department of 60 Nurse Case Managers (NCMs) who are responsible for coordinating the discharge planning for BIDMC inpatients. They employ Interqual criteria as a tool for utilization review in determining patients’ levels of care.

NCMs partner with physician leaders, take daily calls, consult in challenging situations, and problem-solve with the medical staff. The medical center's case management program is staffed seven days a week, and includes dedicated coverage in the emergency department.

Job Description

Nurse Case Management is a department of 60 Nurse Case Managers (NCMs) who are responsible for coordinating the discharge planning for BIDMC inpatients. They employ Interqual criteria as a tool for utilization review in determining patients’ levels of care.

NCMs partner with physician leaders, take daily calls, consult in challenging situations, and problem-solve with the medical staff. The medical center's case management program is staffed seven days a week, and includes dedicated coverage in the emergency department.

Job Summary: The BIDMC Nursing Mission is to build on a legacy of nursing excellence by caring with compassion, advancing the art and science of nursing, and advocating for the health of patients, families, and communities.

The Nurse Case Manager provides utilization management, care coordination and discharge planning for an assigned patient case load. This role is patient-focused, outcome-oriented and based on a general and speciality professional standards, and functions within a multidisciplinary practice model.

Training, evaluation and competencies for this role are overseen by a Nurse Leader to the department.

Essential Responsibilities

Conducts concurrent daily chart review, investigating patient history, symptoms, clinical status, and treatment utilizing Interqual ISD criteria as a tool to determine a patient's severity of illness and the intensity of service.

Works with multidisciplinary team to develop treatment plans, including contingency plans.

Leads daily case management rounds on assigned unit. Participates in house staff rounds.

Provides necessary information to appropriate organization to obtain continued stay certification; assesses payers' and referring physicians' needs in regard to content and frequency of communications.

Facilitates early referrals to social work, rehab services, patient advocacy, and quality management as needed.

Refers cases as appropriate to the Utilization Review Physician for review and determination of need for continued stay or alternate healthcare setting.

Identifies clinical issues and lapses in standards of care and notifies appropriate parties.

Required Qualifications

Associate's degree in Nursing required. Bachelor's degree in Nursing preferred.

• License Registered Nurse required.
• 1-3 years related work experience required.

Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.

Preferred Qualifications

• Certified Case Manager.
• Previous clinical nursing experience and/or case management experience.

Competencies

Decision Making: Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area.

Problem Solving: Ability to address problems that are highly varied, complex and often non-recurring, requiring staff input, innovative, creative, and Lean diagnostic techniques to resolve issues.

Independence of Action: Ability to set goals and determines how to accomplish defined results with some guidelines. Manager/Director provides broad guidance and overall direction.

Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.

Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.

Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.

Team Work: Ability to lead and direct multiple collaborative teams for large projects or groups both internal and external to the Medical Center and across functional areas. Results have significant implications for the management and operations of the organization.

Customer Service: Ability to provide a high level of customer service and staff training to meet customer service standards and expectations for the assigned unit(s). Resolves service issues in the assigned unit(s) in a timely and respectful manner.

Age Based Competencies

Employees in this job must be competent to provide patient care to the following age groups: Neonatal: Birth to 6 months, Young adult: 16-30 years, Middle Age: 30 - 60 years, Elderly: 60 -.

Physical Nature of the Job

Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally

Pay Range

$39.14 - $101.14

The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time.

Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.

Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled