RN Care Coordinator-Complex Case Manager

Position: RN Care Coordinator-Complex Case Manager

Department: Care Management

Schedule: Full Time 10am-6pm

EXPERIENCE:

• 3-5 years of diversified clinical experience is required, certification 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:

• A minimum of 3-5 years recent clinical experience required, and 1-3 years of recent acute, Inpatient Care Management experience required.

• Ability to understand confidentiality and the legal and ethical issues pertaining to patient health; understand medical terminology, how to obtain an accurate history; establish treatment goals; establish working relationships with referral sources; develop treatment plans.

• Knowledge and understanding of methods for assessing an individual's level of physical/mental impairment; understand the physical and psychological characteristics of illness; ability to assist individuals with the development of short- and long-term health goals.

• Ability to understand the requirements for prior approval by payer; be able to evaluate the quality of necessary medical services; be able to acquire and analyze the cost of care; understand the various health care delivery systems and payer plan contracts; be able to demonstrate cost savings.

• Ability to understand case management philosophy and principles; apply problem solving techniques to the care management process; document care management services; understand liability issues for care management activities.

• Knowledgeable on how to access and evaluate the available resources to meet a client's needs; able to develop new resources.

• Excellent interpersonal, verbal, and written communication and negotiation skills

• Strong analytical, data management and PC skills.

• Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.

• Understanding of pre-acute and post-acute venues of care and post-acute community resources.

• Strong organizational and time management skills, as evidenced by a capacity to prioritize multiple tasks and role components.

• Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.

• Ability to partner with post acute facilities to move patients to the next level of care that are considered long length of stay with difficult dispositions and possible insurance barriers

• Work with the Director and senior leadership team to come up with solutions for a patient to propose to senior leadership.

• And any other duties to be assigned by the hospital, department, or director

Compensation Range:

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Equal Opportunity Employer/Disabled/Veterans

According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or "apps" job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.