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Case Manager

Lowell, MA

Department
Circle Home
Job ID
9052
Schedule
Full Time
Shift
Days

Description

Position Summary:
 
The RN Case Manager is responsible and accountable for the management of care for an assigned patient population by service line and across the continuum of care. The RN Case Manager works to achieve daily clinical, quality and cost outcomes by providing well-coordinated experiences for patients/families through the synchronization of care activities of multiple disciplines and negotiation with third party payers.
 

  • Demonstrate great assessment skills and knowledge to accurately develop and implement a comprehensive care plan specific to the identified need/s.
  • Coordinate all aspects of the patient's care plan including by not limited to home health care / hospice referrals, home infusion services, DME, transportation, etc.
  • Facilitate communication and coordination among members of the interdisciplinary team. Involve the patient in the decision-making process in order to minimize fragmentation in the services provided.
  • Communicate the patient's preferences, serving as their advocate and verifying that interventions meet their individualized needs and goals of treatment.
  • Provide information about resources and options available in the community and coordinate service delivery.
  • Identify and address client risk factors and/ or obstacles to care
  • Educates the patients and families regarding various symptoms and consequences related to their specific diseases, conditions and treatment.
  • Completing indicated notifications for and pre-authorizations of services and medical necessity reviews based on payer's requirements and utilization management procedures.
  • Weekend and holiday rotation, every 4th or 5th weekend, subject to change
  • Hours 8:30 -5:00
Qualifications: 
  • MA licensed RN with BSN or equivalent preferred.
  • 2+ years of clinical experience
  • Some discharge planning or case management experience preferred.
  • Requires strong written and verbal communication skills.
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