Care Management Manager

At Boston Medical Center‑Brighton our nurses are changing the face of healthcare. At every level and on every unit, BMC Brighton nurses are advancing professional practice and delivering evidence‑based care to our patients, families, and community. Boston Medical Center Health Systems is one of the top places to work in health care; we know that providing exceptional care for patients begins with caring for our staff.

That’s why you’ll find a supportive work environment at BMC Brighton with rich opportunities throughout your career for training, development, and growth and where you’ll have the tools you need to take charge of your own practice environment.

Provides complex case management for the Case Management department. Accountable for working on long length of stay cases to help with throughput and flow in the hospital. Coordinates special projects and works closely with social workers in guardianship cases and discharge planners to provide information needed to help facilitate the discharge. Utilizes nursing techniques and theory to consult on, assess, and intervene with high‑risk patients and their families regarding the impact and amelioration of medical and physical problems.

• Provides complex case management for the Case Management department.
• Accountable for working on long length of stay cases to help with throughput and flow in the hospital.
• Coordinates special projects and works closely with social workers in guardianship cases and discharge planners to facilitate discharge.
• Utilizes nursing techniques and theory to consult on, assess, and intervene with high‑risk patients and their families regarding medical and physical problems.
• Performs other duties as assigned.

• BSN from an accredited school of nursing.
• Licensed to practice as a registered nurse in the Commonwealth of Massachusetts.
• 3‑5 years of clinical experience, including 1‑3 years in an inpatient care management setting.

• Master’s degree in nursing preferred.
• 2 years of leadership experience preferred.
• Experience working in a unionized environment preferred.

• Massachusetts RN license that is current and active.
• BLS certification required.
• ACLS certification preferred.

• Ability to understand confidentiality and the legal and ethical issues pertaining to patient health.
• Understanding of medical terminology and ability to obtain an accurate history.
• Ability to establish treatment goals, working relationships with referral sources, and develop treatment plans.
• Ability to assess an individual's level of physical/mental impairment and to develop short and long‑term health goals.
• Understanding of payer prior approval requirements, evaluation of quality of necessary medical services, and analysis of cost of care.
• Knowledge of health care delivery systems, payer plan contracts, and cost‑saving opportunities.
• Understanding of case management philosophy and principles, problem‑solving techniques, documentation, and liability issues.
• Knowledge of resources to meet a client’s needs and ability to develop new resources.
• Strong analytical, data management, and PC skills.
• Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.
• Understanding of pre‑acute and post‑acute venues of care and post‑acute community resources.
• Excellent interpersonal, verbal, and written communication and negotiation skills.
• Strong organizational and time‑management skills; able to prioritize multiple tasks.
• Ability to work independently and exercise sound judgment with physicians, payers, and patients and families.

• Competitive pay
• Staff self‑scheduling
• Weekend shift differentials
• Highly subsidized medical, dental, and vision insurance options
• Nurse staffing plans that often exceed state standards for quality and safety
• Employee Referral Program for Registered Nurses up to $7500
• Supportive work environment with a focus on training, professional development, and growth
• Compensation Range: $94,500.00–$
• Generous total compensation including bonuses, merit increases, flexible spending accounts, 403(b) savings match, paid time off, and resources to support employee and family well‑being

Equal Opportunity Employer/Disabled/Veterans. According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps.” Job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.