Nurse manager Jobs in New Bedford, MA

Sippican Rehabilitation and Healthcare Center -

Case Manager (Registered Nurse)

Full-Time Salary Position

Sippican Rehabilitation and Healthcare Center

POSITION SUMMARY : Interacts with representatives of managed care companies to case manage the continuation of stay of managed care residents. Manage chart review, analyze skill level in collaboration with the interdisciplinary team.   With residents and families, communicates patients' progress, obstacles, and insurance status.

POSITION REQUIREMENTS - Education / Experience

State of MA RN / Licensed Practical Nurse in good standing.

Minimum of two (2) years’ experience in a long-term or post-acute setting.

Medicare and / or Managed Care regulation experience.

Ability to read, write, and comprehend English; ability to follow oral and written instructions.

Fluent knowledge of the MS Office suite and other office equipment.

Ability to work hours as scheduled based on the requirements of the position assignment.

Physical Requirements :

Must be able to move intermittently throughout the day, proper body mechanics required. Ability to perform physically demanding work involving frequent bending, stooping, turning, stretching, and reaching above the shoulders is required.

Must be able to see and hear or use prosthetics / equipment that will enable these senses to function adequately to assure that the requirements of this position can be fully met.

Must be able to lift a minimum of 50 lbs.

BEHAVIORAL COMPETENCIES

Accountability

The demonstrated ability for ownership of all actions and behaviors in fulfilling job responsibilities in a manner consistent with the organization’s Mission and values. Includes attending all required and mandatory annual in-services.

2. Communication

The demonstrated ability to present ideas and information in a concise, effective, and interpersonally appropriate manner, through written and oral forms. Recognizes emergencies and responds and / or communicates appropriately. Willingly discusses any problems, needs, or concerns that arise with the Supervisor.

3.  Customer Service

The demonstrated ability to develop and cultivate mutually beneficial relationships with both internal and external customers, including but not limited to coworkers, residents, families, and physicians. Effective customer service behavior is characterized by continually striving to exceed all customer expectations. Service is characterized by responsible and caring stewardship, which assures the dignity of all individuals and the effectiveness of the organization.

4. Leadership

The demonstrated ability to proactively envision and implement organizational goals and to align resources to achieve those goals. Leadership is characterized by the ability to effectively communicate, utilize critical thinking skills to enhance positive performance by others while assuming the responsibility in supporting the Organization in promoting and maintaining positive employee relations and effective communications among facility staff and the awareness for continuous self-development.

5. Teamwork

The demonstrated ability to establish effective relationships with both internal and external customers, including but not limited to coworkers, residents, families, and physicians. Willingly assists other personnel if requested. Teamwork is characterized by working toward a shared purpose or goal by collaboration, partnering, or cooperating with others.

6. Trust and Respect

The demonstrated ability to be both trustworthy and trusting of others while respecting the needs of all residents, family, and coworkers. Modeling the goals and philosophies expressed in the organization's Mission and Code of Ethics. This competency is characterized by actions and behaviors that contribute to creating an environment where all individuals’ rights are respected and upheld and are treated equitably and with dignity.

TECHNICAL COMPETENCIES

Liaison with management, nursing, social services, and admissions for case management determination.

Understands and upholds responsibilities concerning safety, accidents, and fire prevention.

Understands and upholds the Resident’s Bill of Rights and holds all resident information confidential.

Follow and comply with all State and Federal regulations as well as established Personnel Policies and Procedures.

Maintain all pertinent records in a timely, efficient, and confidential manner.

Project a professional image always.

ESSENTIAL FUNCTIONS

Manages the Medicare Notice of Non-Coverage process, including but not limited to staying current with regulatory changes, timely notification of patients / responsible party, instructing facility staff in required tasks, etc.

Completes managed care assessment reports.

Communicates pertinent information as needed with managed care company representatives.

Maintains managed care contracts and ensures facility adherence to contractual stipulations in the delivery of care.

Ensures managed levels of care align with the patient’s individualized plan of care and seeks to reconcile noted exceptions (i.e., high-cost pharmaceuticals, wound vacs, etc.)

Evaluates patient needs and recommends optimal care based on available resources.

Provides feedback to the facility concerning resident / family satisfaction.

Attends pertinent meetings and programs as directed by the Director of Nursing (e.g., Medicare / Care Plan).

Participates in 72-hour meetings and collaborates with Social Services pertaining to discharge planning.

Performs other related duties and attends meetings as may be deemed necessary by the Administrator.