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Boston Medical Center (BMC)

RN Case Manager, 4W, 40 Hours (Days / 4x10 Hour Shifts / Every 6th Weekend)

Boston Medical Center (BMC), Boston, Massachusetts, us, 02298

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Position Summary Utilizing a collaborative process, the RN Case 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 case 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 handle increased volume and support the overall care management process and the department.

Job Details Title:

RN Case Manager Schedule:

40 Hours (Days / 4x10 Hour Shifts / Every 6th Weekend) Department:

4W

Education & Licensure

Graduate of an accredited ASN/BSN Program in Nursing

Licensed to practice as a Registered Nurse in the Commonwealth of Massachusetts

Certifications

CCM or related certification attained within 24 months from hire date is preferred

Required Experience

Minimum 3-5 years recent clinical experience

Minimum 1-3 years recent acute inpatient Care Management experience

BSN preferred and Massachusetts RN license required

Skills & Knowledge

Strong communication, collaboration, and problem‑solving skills

Knowledge of utilization review, discharge planning, managed care, and community resources

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 a 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

Equal Opportunity Statement Equal Opportunity Employer/Disabled/Veterans

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