Manager of Medicare Transition Management

Management RN Role With a Nationally Recognized Organization

  • Boston, MA
  • $135,000 - $165,000
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A bit about us:

Renowned and well recognized hospital in Boston is looking for a Management RN for a new program.
This is and opportunity to work for one of the largest hospitals in New England.

If you are interested in working with an established health care system please reach out to me at:

949.946.4847– Feel free to call or text
Michael.Gartman@jobot.com – Feel free to send a confidential resume

Why join us?

  • Amazing benefits! Free healthcare for employees and their families!
  • Enormous Growth Opportunities
  • Great culture for all nursing staff
  • Parking available on campus

Job Details

Transitions of Care Program is being launched as part of a overall strategy of improving care and reducing readmissions for patients who are over 65 and insured by Medicare. The goal of this program is to provide an additional layer of support to patients who are discharging from the hospital to a skilled nursing facility or to their homes. This program will support patients in the 30-60 days after hospital discharge and provide wrap-around care for patients.

As a member of the team, the manager directly oversees front-line care management (CM) staff working in a transitional care management program. This program is designed to support patients as they are leaving the hospital and transitioning home or to a SNF and entails approaching eligible patients admitted to the hospital, assisting with the discharge planning process, and following the patient post-discharge. Patients will receive a minimum of two home visits from a RN or NP after their hospital discharge. The care management staff function independently but are closely integrated with patient care teams, with the goal of supporting the patient in the immediate post hospital discharge period, identifying clinical decompensation and/or barriers to care, and coordinating with the patient’s routine outpatient providers to transition the patient back to routine care. The TCM model is an evidence-based model of transitional care that has been studied in several trials and shown to improve outcomes and reduce costs among high risk patients leaving the hospital.

The manager will spend the majority of his/her time interacting directly with the CM teams, as well as the local ED, Inpatient, Primary Care and specialty teams. The TCM team is comprised of Nurse Practitioners, Nurses and Community Wellness Advocates (CWAs), and may include social workers as well. The Manager will oversee staff and will collaborate with multi-disciplinary team members including pharmacists, behavioral health professionals, and others.

The Manager will be responsible for building a high-performing care management team. He/she will recruit, hire, and onboard staff who are passionate about social justice, caring for vulnerable elderly patients, and clinical excellence. Given that staff will be located across the inpatient, ambulatory and community settings, it will be critical for the managers to build a team culture and sense of community that overcomes geographic separation across team members. He/she will be responsible for continuous improvement of the care management process, as well as the continued growth and development of his/her team.
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Job Details
Location
Boston, MA
Job Type
Permanent
Compensation
$135,000 - $165,000