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Beth Israel Lahey Health Nurse Case Manager - per diem in Cambridge, Massachusetts

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Job Type:

Per Diem

Scheduled Hours:

0

Work Shift:

Day (United States of America)

Mount Auburn Hospital (MAH) is a 200-bed acute care teaching hospital affiliated with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for MAH inpatient admissions. Inpatient Case Manager performance is evaluated using the Inpatient Case Manager Guidelines and audit tool. Reports to Inpatient Case Management Supervisor.

Job Description:

Primary Responsibilities (including but not limited to):

  1. Performs utilization review and discharge planning to inpatient admissions to MAH.

  2. Applies InterQual Inpatient criteria approved by the MACIPA (risk) and MAH (non-risk) Utilization Management Committees to accurately determine appropriateness for inpatient and outpatient care.

  3. Communicates with attending and house staff when options to inpatient care are identified.

  4. Utilizes clinical expertise to determine the appropriate level of care for patients. Leads the healthcare team in selecting appropriate, safe, hospital or alternative care options.

  5. Works with MAH nursing and social work staff to coordinate and facilitate patient discharge.

  6. Identifies days not meeting acute hospital level of care criteria and reports them to the physician reviewer.

  7. Works with patients and families to facilitate post hospital care and develop plans to meet short and long-term needs.

  8. Accurately manages observation status patients by working with physicians to ensure appropriate utilization.

  9. Is part of the department’s weekend, holiday, and beeper rotation schedule as needed.

  10. Adheres to all insurance, contractual, and regulatory requirements as mandated.

  11. Abides by MACIPA Case Management standards as per the MACIPA CM guidelines.

Required Qualifications:

  1. Bachelor’s degree preferred. Current state license as a Registered Nurse.

  2. Three years of medical/surgical nursing care experience. Two years of case management or utilization management experience required.

  3. Basic computer and typing skills.

  4. Effective verbal communication skills and problem-solving and negotiation skills.

  5. Demonstrated ability to organize and work independently.

FLSA Status:

Exempt

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled

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