RN Care Manager, Emergency Department, 40 Hours (Day/Evening)
Boston Medical Center (BMC)
Position Summary
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 to obtain optimum value for both the patient and the reimbursement source. This role is dedicated to handling increased volume and supporting the overall care management process and the department.
Licensed to practice as a Registered Nurse in the Commonwealth of Massachusetts
CCM or related certification preferred within 24 months of hire date
Experience
3‑5 years of diversified clinical experience, including care management required
Emergency Department experience preferred
Minimum 2 years of experience involving judgment and decision making, preferably in a utilization/case management position
Knowledge & Skills
Extensive background and knowledge of current medical/surgical patterns of practice.
Medical terminology and standard medical abbreviations.
Managed care concepts and various health care delivery systems.
Methods for assessing an individual’s 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 negotiation skills.
Strong analytical, data management and PC skills.
Schedule
40 Hours (Day/Evening). Day/evening rotation to meet departmental needs. Every 6th weekend.
Compensation Range
$38.05 - $56.69 per hour. Includes benefits such as medical, dental, vision, pharmacy coverage, contract increases, flexible spending accounts, 403(b) savings match, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.