Job description
The Employee once trained will be on -call weekends and Holidays. Must be prepared to come into the hospital if called.
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DEFINITION/PRIMARY FUNCTIONSThe case manager is responsible and accountable for managing the healthcare needs and facilitating the achievement of quality and cost outcomes of all patients within Fairview Hospital and across the continuum. The case manager, utilizing a multidisciplinary team approach, negotiates, procures, coordinates and monitors services and resources needed by patients. The case manager is responsible for reviewing the patient at admission and in some instances prior to admission, and through the hospital stay for the appropriate level of care and utilization of resources. The case manager will do discharge planning to assure appropriate post hospital care and will monitor the patient during the course of their hospitalization. The case manager participates with the Performance Improvement Initiatives undertaken by Fairview Hospital and Berkshire Health Systems.
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POSITION QUALIFICATIONS (Minimum qualifications are required unless stated otherwise.)
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Experience:One year recent experience specializing in utilization management, discharge planning, case management or insurance review preferred.
Three years recent clinical practice in acute care preferred.
Experience in home care, sub-acute care, or long term care desirable.
Knowledge of regulatory policies and governing bodies preferred. -
Education and Training:
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Registered Nurse from an accredited school.
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Bachelor’s Degree in nursing or other related field required.
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Master’s Degree in health care or business desirable.
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License, Certification & Registration:
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RN License - Currently licensed as an RN in Massachusetts
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Other Requirements:Ability to speak, read and write the English language in an understandable manner.
Proven excellent interpersonal and communication skills; Ability to maintain confidentiality; Proven collaboration skills with other disciplines; Proven ability to work independently; Proven excellent organizational skills; Demonstrated ability to establish and maintain relationships with physicians; Knowledge of local community resources preferred; Knowledge of Medicare, Medicaid, payor and reimbursement preferred; Computer experience required; Data Management skills preferred; Skills in data comprehension, research, analysis, interpretation and judgement necessary to prepare a comprehensive summary report for files, management and/or regulatory agencies when appropriate.
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Location: Berkshire Health Systems · FVH Case Mgt/Social Svcs
Schedule: Full Time, Shift 1, 8:00am to 4:30pm
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