Utilizing a collaborative process, the care manager will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual’s health needs, using communication and available resources to promote quality, cost-effective outcomes. The care manager helps identify appropriate providers and facilities throughout the continuum of services while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the patient and the reimbursement source. This care manager is dedicated to handle the increased volume and to support the overall care management process and the department.
Position: RN Care Manager
Department: Care Management Float Pool
Schedule: Per Diem
JOB REQUIREMENTS
EDUCATION:
Graduate of an accredited BS Program in Nursing
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 is required
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
Compensation Range:
$38.05- $75.33
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
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Boston Medical Center (BMC) is a 511-bed, equity-led academic medical center and a proud member of the Boston Medical Center Health System. BMC delivers a model of healthcare where innovative and equitable care empowers all patients to thrive. As a premier academic medical center in Boston, a national leader in clinical care, and the largest essential hospital in New England, BMC’s world-class clinicians provide comprehensive care in more than 70 specialties and subspecialties.
BMC understands that health equity is foundational to community wellbeing, and it requires transformative thinking, rewriting policies that have historically underserved communities, creating access to cutting-edge care for all, and co-creating programs with community partners that serve as national models for improving patient outcomes and experiences. We are invested in going above and beyond what is traditionally considered medicine to meet the needs of our communities and address disparities in clinical care and beyond.
By pioneering cutting-edge research and advancing scientific discovery, we are fostering a culture of innovation where novel treatments and therapies are not only effective but also accessible.
Boston Medical Center Health System is an integrated academic healthcare system that models a new kind of excellence in healthcare where clinical and operational innovation meets health equity and access. With more than 15,000 dedicated employees, BMC Health System is committed to advancing scientific discovery and access to care, partnering with our communities, and developing scalable approaches to restore and maintain health.
Visit jobs.bmc.org for career opportunities.
