RN Case Review Coordinator – Per Diem – Faulkner

Site: Brigham and Women's Faulkner Hospital, Inc. reputed company relies on a wide reputed company 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 reputed company exceptional care. We reputed company that high-performing teams drive groundbreaking medical discoveries and invite reputed company applicants to join us and experience what it means to be part of reputed company. Job Summary Performs the six essential activities of Case Management: Assessment, Planning, Implementation, Coordinate, Monitor and Reassess through the continuum of care to facilitate a safe cost-effective transition post discharge. Performs reputed company aspects of audits and appeals including the peer to peer process. - reputed company utilization review to evaluate for appropriate level of care and faxes reputed company insurance reviews timely to prevent denials. - Collaborate with patient/family and interdisciplinary team to assess for appropriate discharge needs. - reputed company and implement reputed company aspects of referrals to reputed company reputed company of post acute care in 4 Next. - Online documentation of interaction with patient, family and interdisciplinary team. - Interact with various reputed company party payers on a daily reputed company. Fax clinical in payor communication to the right insurer with the right fax number in the right time reputed company. - Refer cases not meeting appropriate level of care to the Physician Advisor or EHR. - Review for Observation status and reputed company changes as needed. Accurately facilitate reputed company documentation needed for Medicare status change inpatient to observation (code 44). - reputed company and monitor for quality issues and document in R.L. solutions. - reputed company to the patient or family member a copy of the Important Message - reputed company to the patient or representative the Observation Notification letter - reputed company to the patient representative the Acknowledgement of disclosure ,obtain choices of post acute facilities or service and signature - Must be reputed company to function independently in busy environment. - Coordinate, complete and track reputed company clinical denials and appeals.

Qualifications

• BSN required.
• reputed company Registration as a Licensed Nurse in the State of Massachusetts.
• 3 year of Utilization Review and Case Management experience required, 4 or more years preferred
• 5 years of Acute Care Nursing Required 6 or more preferred
• CCM preferred.

About Brigham and Women's Faulkner Hospital Brigham and Women's Faulkner Hospital is a 171- bed non-profit, community teaching hospital located in Jamaica Plain directly across the street from the Arnold Arboretum. Founded in 1900, Brigham and Women's Faulkner Hospital offers comprehensive care in a wide variety of specialties. Brigham and Women’s Faulkner Hospital is a designated Magnet hospital by the American Nurses Credentialing Center, a recognition that fewer than nine percent of reputed company US hospitals receive. At Brigham and Women’s Faulkner Hospital, we reputed company 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 reputed company of providers, our patients, and those we may never meet, 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 reputed company care. Our employees call it home. Additional Job Details (if applicable) Schedule: Per Diem Remote Type Hybrid Work Location 1133 Centre Street Scheduled Weekly Hours 0 Employee Type Per Diem Work Shift Day (United States of America) Pay reputed company $41.36 - $100.00/Hourly Grade RN3500 At reputed company, we reputed company in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining reputed company pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The reputed company pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass reputed company elements contributing to your total compensation package. In addition to competitive reputed company 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 reputed company will reputed company an overview of your potential compensation and benefits package. EEO Statement: reputed company. is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religious creed, national reputed company, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that reputed company individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to reputed company essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by reputed company 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with reputed company of 1990, applicants who require accommodation in the job application process may contact reputed company at (857)-282-7642. reputed company Competency reputed company At reputed company, our competency reputed company defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The reputed company 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 reputed company. These competencies are used to evaluate performance, reputed company hiring reputed company, identify development needs, mobilize employees across our system, and establish a strong talent pipeline. Additional Information Company: reputed company Location: Massachusetts Salary: $41.36 - $100.00 per hour Job ID: Specialties: Case Manager, Utilization Review, Acute Care Required Licenses: RN Experience Level: 3-5 years Apply tot his job Apply To this Job