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    Registered Nurse-Homeworking - Shrewsbury, Shropshire, United Kingdom - University of Massachusetts Medical School

    University of Massachusetts Medical School
    University of Massachusetts Medical School Shrewsbury, Shropshire, United Kingdom

    1 week ago

    Default job background
    Description
    Nurse Rev II-Case Management (Home Based with Client Visits)
    Nurse Rev II-Case Management (Home Based with Client Visits)

    Job Number :
    Healthcare


    Shift:
    Day


    Business Unit:
    ForHealth Consulting
    ForHealth Consulting - Community Service - W401950


    Job Type:
    Full-Time

    Under the general supervision of the Associate Director, or designee, the Nurse Reviewer II is responsible for providing administrative case management as part of the Community Case Management Program.

    This position is responsible for the authorization, coordination and facilitation of community long term care services for program Members.

    As a member of a multidisciplinary team, the Nurse Reviewer II is responsible for assessing, planning, organizing, reviewing and evaluating the care needs of Members requiring community based services.

    This position fosters and promotes continuity of care and cooperative partnerships by liaising with nursing providers, state agency staff, acute care hospitals and other programs/organizations involved in the provision of services.

    Contribute as an active member of a multi/inter-disciplinary team to assess, plan, organize, review and evaluate the care needs of Members requiring health care services, to include outpatient and home based therapy services.

    Conduct on-site reviews and assessments of Members community long term care needs to determine medical necessity and clinical eligibility for Community Case Management and Continuous Skilled Nursing Services Determine and authorize services for Members in accordance with program guidelines and regulations.

    Review and document all relevant information into data system applications in accordance with program guidelines and regulations.
    Conduct routine and ad-hoc evaluations and re-evaluations of Members services.

    Foster and promote continuity of care and cooperative partnerships by liaising with health care providers, acute care hospitals and other programs/organizations involved in the provision of services.

    Maintain the confidentiality of all business documents and correspondence per UMass Chan Medical School/ForHealth Consulting procedures and HIPAA regulations.

    Participate in performance improvement initiatives and demonstrates the use of quality improvement in daily operations.
    Comply with established departmental policies, procedures and objectives.
    5-7 years of work experience with at least 3 recent years providing direct service or case management to pediatric patients or young adults with special needs
    ~ Ability to travel statewide to Member homes and service providers places of business
    ~ Experience with Office Application and database

    Experience with home care
    Hybrid Remote. Work from home based, with statewide travel to client homes/sites for in person visits approximately 1-2 times per week
    Seeking candidates with experience caring for the medically complex pediatric, young adult, or adult populations. Home care experience preferred.

    UMass Chan Medical School was among 23 companies that stood out as 2023 "DEI champions," according to The Boston Globe.

    News & World Report
    "2023 BEST MEDICAL GRAD SCHOOL"
    for Primary Care and Research
    #
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