Site: Brigham and Women's Faulkner Hospital, Inc.

 

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

 

 

Job Summary

Schedule: Per Diem

Why YOU should be our newest Case Review Coordinator:
Performs the six essential activities of Case Management: Assessment, Planning, Implementation, coordinating, monitoring, and Reassessing through the continuum of care to facilitate a safe, cost-effective transition post-discharge.
Performs all aspects of audits and appeals, including the peer-to-peer process.
Perform utilization review to evaluate for the appropriate level of care and fax all insurance reviews timely to prevent denials.
Collaborate with patient/family and interdisciplinary team to assess for appropriate discharge needs.
Interact with various third-party payers on a daily basis.
Review for Observation status and make changes as needed.

 

Qualifications

Bachelor's Degree Nursing required3 year of Utilization Review and Case Management experience preferred or 4 or more years of Utilization Review and Case Management experience preferred5 years of Acute Care Nursing required or 6 or more of Acute Care Nursing preferredStaff adheres to all I C.A.R.E. Standards.Demonstrates knowledge, skills and abilities to work with various age groups in order to provide a safe discharge plan.Must be able to provide care for the patient despite psychosocial, educational, or physical disability.Basic computer skills, experience with Excel and Word, and good computation skills.Ability to interact and communicate within a diverse community.Competent in Utilization Review, appeals, the peer-to-peer process, and Case Management.Use critical thinking skills in all interactions and recognize the need to be solution-driven.Good negotiating skills with insurance companies and third-party payers.Performs all aspects of discharge planning to the right environment of care, timely.Proficient in the use of ECare.

Who We Are:

Brigham and Women’s Faulkner Hospital is an affiliate of Mass General Brigham committed to supporting patient care, research, teaching, and service to the community. 

Brigham and Women's Faulkner Hospital is a 171- bed non-profit, community teaching hospital located in Jamaica Plain.  Founded in 1900, Brigham and Women's Faulkner Hospital offers comprehensive care in a wide variety of specialties.  We are a Magnet designated hospital, a recognition that fewer than nine percent of all US hospitals receive. We believe that everyone should have the chance to live a healthy life. From creating breakthroughs that have paved the way for treatments around the globe to training the next generation of providers, our patients are at the center of everything we do. If you’re looking for more than a career, join Brigham and Women’s Faulkner Hospital.  Our patients call it better care.  Our employees call it home.

 

Additional Job Details (if applicable)

 

Remote Type

Onsite

 

Work Location

1153 Centre Street

 

Scheduled Weekly Hours

0

 

Employee Type

Per Diem

 

Work Shift

Day (United States of America)

 

Pay Range

$39.77 - $93.85/Hourly

 

Grade

RN3500

 

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

 

EEO Statement:

Brigham and Women's Faulkner Hospital, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

 

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.