Case Manager, Registered Nurse/Licensed Practical Nurse Job at Whittier Health Network, Framingham, MA

Y2ZYaHo0cFFBZTF4WGVWWHcyVUVMT05sNkE9PQ==
  • Whittier Health Network
  • Framingham, MA

Job Description

Case Manager, Registered Nurse/Licensed Practical Nurse - Oak Knoll Healthcare Center
Full-Time, 40 hours/week - all shifts
Base Pay :  $40.00-48.00

Essential Duties : To provide exceptional care to all residents including but not limited to:
-Coordinates and oversees each Medicare and Managed Care patient`s care from admissions through post-discharge follow-up
-Maintains communication between interdisciplinary team, patient/family and external case managers from payors or other facilities.
-Continuously monitors documentation to meet guidelines or standards developed by the regulatory agencies
-Services as a reimbursement specialist and resource person
-Participates in admission process and admission meetings, reviews screen referrals
-Begins assessment of discharge planning needs on admission
-Develops pre-admission treatment plan as required, to include specific objectives, goals and interventions
-Implements and reviews treatment plan and length of stay in accordance with predetermined criteria.
-Evaluate, assess and modify the plan as needed throughout the stay including nursing and rehab services
-Coordinates, monitors and documents overall progress toward stated goals as needed
-Communicates with patient and/or family regarding plan of care, discharge planning and reimbursement issues
-Communicates verbally, via telephone, in writing and/or via fax with payor/external case managers regarding progress, changes in the patient condition and plan modifications, advocating services at an appropriate intensity to best meet the patients’ needs
-Obtains authorization for continued stay.
-Obtains authorization and approvals as needed regarding coverage for third party payors, extra-contractual services or recommended treatment plans
-May coordinate and provide termination of benefits letters provided by payor/external case managers  Responsible for ongoing management of discharge planning in collaboration with Social Services.
-Coordinate clinical discharge summaries with nursing staff
-Attends interdisciplinary team meetings weekly and as needed.
-Evaluates and makes adjustments to the overall plan as needed
-Attends family conferences where information relating to the status of the patients’ progress is discussed as needed
-Coordinates and attends team rounds weekly
-Coordinates through Central Supply equipment ordering/specialized mattress ordering and sign off as required  
-Communicates to billing medical records and rehab all level changes.
-Follow up on billing issues as needed Conducts/attends regularly scheduled staff meetings when required
-Coordinates serviced rendered by nursing personnel with those rendered by personnel of other departments  
-Accurately documents all case management activities in the patients’ medical record  
-Reviews medical record documentation and monitors for compliance per facility policy and regulatory agency requirements for all departments  
-Assists in completion of MDS process, as needed  

Prerequisites:  
- Graduate of an accredited Registered Nurse school of nursing
- Current and active RN OR LPN license in the state of Massachusetts
- Current certification in Basic Cardiac Life Support in accordance with AHS or ARC standards
- Minimum of five (5) years recent clinical experience preferably in long-term care
- Effective written and verbal communication skills
- Prior Utilization Review and/or Case Management experience required

Benefits available:
-401k
-Paid Sick
-Paid Vacation
-Paid Holiday
-Medical
-Dental
-Vision
-Life
-Short and Long Term Disability
-Hospital and Accident policy
-Critical Illness
-Christmas Club
-Flexible Spending Accounts
-Health Savings Account

Job Tags

Holiday work, Full time, Temporary work, Christmas work, Flexible hours, All shifts,

Similar Jobs

Weatherford

Buyer - Procurement Specialist Job at Weatherford

 ...optimize their resources and realize the full potential of their assets. Across our operating locations, including manufacturing, research and development, service, and training facilities, operators choose us for strategic solutions that add efficiency, flexibility, and... 

TJX Companies, Inc.

Key Carrier Coordinator Job at TJX Companies, Inc.

 ...Style is never in short supply at our more than 500 HomeGoods stores and we are constantly on a mission to provide the little surprises and extra touches that make a house feel like home. Same with working here. Our environment is ever-changing, yet always encouraging... 

Equipaws Pet Services

Dog Walker/Pet Sitter Job at Equipaws Pet Services

 ...Love dogs (and cats!)? Join our award-winning team of Pet Care Specialists! Get paid to cuddle pups, enjoy the fresh air, and make...  ...are currently looking for Pet Care Specialists (Dog Walker/Pet Sitter) to join our team of pet-loving individuals. This is an opportunity... 

Class A Jobs 411

Regional Dedicated Truck Drivers | Richmond VA Job at Class A Jobs 411

 ...Now Hiring: Regional Dedicated Truck Drivers Join our team as a regional dedicated truck driver! We are looking for reliable and experienced drivers to cover routes across the Eastern U.S. If youre seeking consistent miles, competitive pay, and bi-weekly home time,... 

KLIM Technologies

Remote Graphic Designer Job at KLIM Technologies

 .... About the role We are looking to expand our team of graphic designers to cope with the increasing demand in graphical assets for new...  ..., adapting to changes smoothly. Have Amazon listing experience (a plus, but not required) What's in it for you? Location...