Job Description

Category:  Registered Nurse/ Nurse Leadership

Facility:  Saint Anne's Hospital

Department:  Case Management

Schedule:  Full-time

Shift:  Day shift

Hours:  

Masters degree is required Provides direct supervision to all RN case managers, social work LICSW supervisor and social work clinicians as well as the health promotion advocate.  Manages activities related to appropriate utilization of the hospital setting and resources as well as the development of expeditious arrangement of post-hospital services in a quality discharge plan. Drafts policies and programs related to the utilization management, discharge planning functions and participation in activities to both. Demonstrates knowledge of third party reimbursement and denial management. Recognizes and identifies appropriate referrals to social work clinicians for behavioral health and psycho social issues. Demonstrates effective organizational skills and has a high level of expertise in all aspects of level of care criteria. Knowledge of community resources for post acute services for high risk patients. Works as a team member with all departments for effective disease management and discharge planning. Focuses staff on efficient and effective problem solving approaches.  BSN required. Master�s in clinical management or related field preferred.  Five to seven years case management, discharge planning or community health nursing experience including three to five years of utilization management in an acute care setting.  Current Massachusetts RN license.

 

 

  

 

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