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Care Manager RN / Geriatric Registered Nurse / RN CCM

RCM Health Care Services Boston, MA
  • Expired: 20 days ago. Applications are no longer accepted.

Care Manager, Geriatrics - Boston Area - Field and Work From Home Combination!

Key Functions/Responsibilities:

  • Completes initial and on-going face to face comprehensive assessment with Enrollees
  • Demonstrates strong knowledge and use of the MDS-HC assessments to maximize placement of Enrollees into the appropriate rating category
  • In conjunction with the Enrollee and the PCT develops a person centered Integrated Plan of Care
  • Facilitates meetings of the PCT
  • Utilizes evidence-based guidelines to assist Enrollees in understanding their disease process and increase their capacity for self-management and optimal health
  • Utilizes evidence-based guidelines to develop Individualized Plans of Care (IPC)
  • Evaluates the effectiveness of the IPC and progress against goals
  • Serves as designated medical clinical care subject matter expert on the PCT
  • Evaluates the effectiveness of alternative care services and ensures that cost effective, quality care is maintained according to standards
  • Facilitates linkage and referral to ASAPS and other community based organizations
  • Documents clinical assessments and coordination of care in the medical management information system in a timely manner that meets regulatory and accreditation standards
  • Ensures continuity of care through effective transition planning
  • Provides culturally competent care coordination in keeping with the Enrollee's racial, ethnic and sexual orientation
  • Utilizes data to ensure that clinical interventions result in improved clinical outcomes and appropriate utilization of services at the right time, right place, and right setting
  • Facilitates sharing of essential clinical or psychosocial information related to the Enrollee's care
  • Maintains HIPAA standards and confidentiality of protected health information.
  • Reports critical incidents and information regarding quality of care issues.
  • Serves and participates in pertinent committees and meetings as needed
  • Assists with new staff training
  • Regular and reliable attendance is an essential function of this position
  • Must have the ability to use a laptop, or tablet for accessing the systems to include documentation in the medical management information system
  • Must use a cell phone and provide on-call services, per a rotating schedule
  • Must become strongly knowledgeable in the full contractual requirements of the SCO Care Management agreement with EOHHS and CMS (D-SNP agreement)
  • Must become proficient in contracts with vendors and agencies of whom organization outsources for the SCO population
  • Must attend meetings at the office(s), as requested by the Management team
  • Must attend PCT meetings which may include early morning or evening meetings

Qualifications:

  • Registered nurse
  • Bachelor's degree or an equivalent combination of education, training and experience is required.
  • Active Massachusetts RN license

Preferred/Desirable:

  • Master's degree in nursing, geriatric NP, or health related/public health field preferred
  • Certification in case management (CCM) preferred
  • Bilingual Spanish, Haitian Creole, Spanish Creole, French Creole
  • 3 years' experience in Medical Case Management working with the geriatric population


Competencies, Skills, and Attributes:

  • Excellent clinical and assessment skills
  • Experience with the Medicaid, Medicare, and Senior population
  • Experience with ASAPs preferred
  • Ability to work collaboratively and build strong relationships with providers, Enrollees, and the PCT
  • Proficiency in InterQual Level of Care through the continuum
  • Excellent working knowledge of Windows and Microsoft Office products
  • Flexible, independent, self-starter with an ability to thrive in a fast paced environment
  • Demonstrates commitment to quality
  • Projects positive, team oriented demeanor
  • Demonstrates strong interpersonal skills including effective listening and ability to support, motivate and guide others
  • Strong oral and written communication skills; ability to interact within all levels of the PCT
  • Demonstrated strong organization and time management skills
  • Demonstrated ability to successfully plan, organize and manage within a person centered integrated care team
  • Detail oriented

RCM Health Care Services

Why Work Here?

Truly a great team and mission with over 40 years in business

RCM Health Care Services’ mission is to provide opportunities for qualified candidates across medical professions. We deliver timely results and have built a reputation of trust with our clients and candidates. Since 1975, we have been providing staffing solutions to many of the finest healthcare institutions across the nation and careers for thousands of candidates. As professional career opportunity matchmakers, we follow up and follow through to help our clients and candidates to reach their career and life goals. We proudly hold the Joint Commission Gold Seal of Approval as well.

Address

Boston, MA
USA