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Job description
When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
nThis role is full-time (40 hours per week) Monday through Friday with a Weekend Rotation shared among Staff.
nCoordinates patient care utilization and discharge planning by applying clinical criteria, collaborating with care teams, and ensuring appropriate levels of care. Supports patient transitions, compliance, quality improvement, and regulatory standards while maintaining strong communication, customer service, and participation in organizational activities.
nJob Description:
nEssential Duties & Responsibilities including but not limited to:
nnnPerforms utilization review and discharge planning to inpatient admissions.
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nnApplies Interqual, AEP and or other review criteria approved by the Clinic to accurately determine appropriateness for inpatient and outpatient care.
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nnUtilizes clinical expertise to determine the appropriate level of care for patients. Leads the healthcare team in selecting appropriate, safe, hospital or alternative care options.
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nnWorks closely with Community Case Managers to collaborate regarding medically fragile and or high risk patients admitted to the clinic.
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nnIdentifies delay days and notifies Team Leader.
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nnReports serious occurrences and sentinel events to Risk Management.
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nnWorks with patients and families to facilitate post hospital care and develop plans to meet short and long-term needs.
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nnAccurately manages observation status patients by working with physicians to ensure appropriate utilization.
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nnIs part of the department’s Saturday, Sunday, holiday and beeper rotation as needed.
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nnSupports all service line activities related to utilization and quality management.
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nnAssists in the development and implementation of clinical pathways.
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nnAdheres to all insurance, contractual and regulatory requirements as mandated.
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nnWorks with Lahey Clinic nursing, social work and other members of the healthcare team to coordinate and facilitate patient discharge.
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nnWorks with the Post Acute Care Coordinator to facilitate timely patient access to post acute care Services.
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nnParticipates in hospital or medical committees representing patient issues and department functions such as case management, utilization and CQI as requested.
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nnIncorporates Lahey Clinic Guiding Principles , Mission Statement and Goals into daily activities.
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nnComplies with all Lahey Clinic Policies.
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nnComplies with behavioral expectations of the department and Lahey Clinic.
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nnMaintains courteous and effective interactions with colleagues and patients.
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nnDemonstrates an understanding of the job description, performance expectations, and competency assessment.
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nnDemonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.
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nnParticipates in departmental and/or interdepartmental quality improvement activities.
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nnParticipates in and successfully completes Mandatory Education.
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nnPerforms all other duties as needed or directed to meet the needs of the department.
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n nMinimum Qualifications:
nEducation:
n• Registered Nurse, Bachelors Degree or commensurate experience preferred.
nLicensure, Certification, Registration:
n• Must hold current Commonwealth of Massachusetts license as a Registered Nurse, and Basic Life Support (BLS)
nSkills, Knowledge & Abilities:
nIn the absence of any of these skills, demonstrates the ability to be thoroughly trained to Proven leadership and project management experience and skill meet organizational standards.
n• Effective verbal communication, problem solving and conflict resolution skills.
n• Basic computer and typing skills.
n• Basic knowledge of Quality Improvement techniques.
n• Demonstrated ability to organize and work independently
nExperience:
n• A minimum of three years of medical/surgical nursing care experience. Two years of case management or utilization management experience desirable.
n• Demonstrated ability to communicate effectively with medical and hospital staffs.
nPay Range:
n$38.11 - $98.23
nThe pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.
nAs a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.
nMore than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.
nEqual Opportunity Employer/Veterans/Disabled
Worksite address
burlington, MA, 01805, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.