Point of Entry ER RN Case Manager - Milford Regional, 24 hours Evenings

UMass Memorial Health · United States

Are you a current UMass Memorial Health caregiver? Apply now through Workday. Exemption Status: Exempt Hiring Range: $84,011.20 - $176,987.20 Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations. Schedule Details: Holidays - Every Third Holiday, Monday through Friday, Weekends - Every Third Weekend Scheduled Hours: 8:00am - 8:30pm Shift: 2 - Evening Shift, 12.5 Hours (United States of America) Hours: 24 Cost Center: 26000 - 4402 Case Management Union: MNA-Milford Regional Medical Center (Massachusetts Nurses Association) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. In collaboration with other members of the healthcare team, the Point of Entry/Emergency Department Case Manager (POE/ED CM) is accountable for coordination and facilitation of the management of care for ED patients, both inpatient and observation. The POE/ED CM manages patient flow through the ED by evaluating incoming patients and assisting in determining appropriate discharge disposition (Home, Post-acute Services, Inpatient, or Observation). This includes early assessment of discharge needs and communication among healthcare team members and family/caregivers. The POE/ED CM collaborates with admitting teams to ensure correct initial admission status using InterQual criteria. I. Major Responsibilities: Patient Identification and Communication

1. Reviews all ED patients promptly.
2. Reviews all admitted patients within one hour of admission or before admitting orders are placed.
3. Intervenes early for patients with progressive conditions or complex needs.
4. Ensures communication among MSW, CM, and ED care team.

1. Completes and documents initial discharge planning assessments.
2. Refers complex or high-utilizer patients for MSW psychosocial assessment.
3. Identifies and documents readmissions for follow-up.

1. Completes admission reviews using InterQual criteria.
2. Collaborates with providers to resolve discrepancies in medical necessity.
3. Documents clinical reviews in Meditech per standards.

1. Executes discharge plans in collaboration with ED and admitting physicians.
2. Prioritizes discharges requiring post-acute care arrangements.
3. Arranges services such as Home Health, DME, SNF, rehab, and medications.

1. Escalates unresolved cases to appropriate leadership.
2. Follows formal escalation processes for utilization and level of care issues.
3. Documents avoidable delays for boarded ED patients daily.

1. Applies knowledge of growth and development stages to patient care.
2. Demonstrates age-appropriate communication and support.

1. Bachelor of Science in Nursing
2. Current Massachusetts RN license

1. Minimum 3 years of medical, surgical, ICU, or ED nursing experience
2. Demonstrated sound judgment and knowledge of medical care and support services
3. Excellent interpersonal and communication skills
4. Analytical ability to evaluate patient care needs and service appropriateness

1. 3–5 years of hospital-based case management
2. Emergency department experience
3. Utilization review experience