"Alerted.org

The Lemuel Shattuck Hospital, operated by the Massachusetts Department of Public Health (DPH), is seeking an experienced healthcare leader to oversee our hospital-wide Case Management program. This pivotal role is responsible for developing and implementing case management policies, supervising daily operations, and coordinating care activities across multidisciplinary teams. The ideal candidate will ensure compliance with all State and Federal regulations related to utilization review and discharge planning, while promoting effective, ethical, and patient-centered care—particularly for populations served by DPH, DOC, DMH, DMR, shelters, and the broader community. Additionally, this role includes marketing and outreach efforts to strengthen relationships with referral sources and supervising screening nurses to ensure alignment with strategic referral goals. */_Please Note Scheduled Hours:_/* * 8-4:30pm Monday-Friday, With Weekends Off /*_Duties and Responsibilities (these duties are a general summary and not all inclusive):_*//*__*/ * /Support hospital administration in contract negotiations with Managed Care Providers and ensure operational alignment with managed care and capitated arrangements./ * /Develop and implement Case Management protocols, including review criteria and processes that align with level-of-care standards and payer requirements./ * /Coordinate appeals and reconsideration processes with managed care agencies and third-party payors./ * /Oversee all daily operations of the Case Management department, supervising a team of seven staff members and ensuring timely admissions, discharges, and service quality for DPH patients./ * /Create and manage databases and reporting systems that provide critical utilization data to Administration, Fiscal Services, and Patient Accounts./ * /Monitor resource utilization for trends in overuse, underuse, and inefficiencies, and report findings to the Utilization Review Committee./ * /Design and lead educational programming—including orientation, in-services, and continued training—for case management staff and hospital-wide teams./ * /Ensure timely and accurate dissemination of utilization management data across departments and maintain compliance with evolving federal, state, and industry regulations./ * /Maintain professional licensure and competencies, including CPR certification, by pursuing ongoing education and participating in professional associations./ * /Champion and participate in hospital Performance Improvement (PI) initiatives by reviewing records and care standards and analyzing data for improvement opportunities./ * /Prepare statistical and narrative summaries on utilization and case management effectiveness for stakeholders./ * /Engage in interdisciplinary and community-based collaboration to support Massachusetts public health programs and initiatives./ * /Provide frequent evaluation of staff performance and oversee continuing education on topics such as infection control, risk management, emergency preparedness, and regulatory compliance./ * /Collaborate with internal teams, families, and external partners (e.g., other healthcare facilities, community agencies) to promote smooth care transitions and maintain a therapeutic environment./ * /Serve as a resource and advocate for staff, families, and visitors by addressing inquiries and complaints and upholding privacy and confidentiality policies./ * /Ensure comprehensive discharge planning, including timely transportation coordination for patients transferring to home or other care facilities./ * /Generate monthly reports analyzing census trends, staff changes, incidents, attendance, and compliance issues to inform operational planning and resource allocation./ * /Supervise staff coordinating daily with physicians to assess admissions and match community resources to patient discharge needs./ * /Act as a liaison to external healthcare partners, providing consultative support and building collaborative relationships./ /*_Required Qualifications:_*//*__*/ * /Strong leadership and management abilities with a proven ability to guide teams effectively./ * /Excellent communication skills and proficiency in writing reports and collaborating across disciplines./ * /Skilled in motivating teams and maintaining composure in high-pressure or emergency situations./ * /Expertise in overseeing care and utilization programs aligned with JCAHO accreditation standards./ * /Experience managing interventions for diverse patient populations, including those with physical, mental, or emotional challenges./ * /Proficient in directing CPR and advanced life-saving procedures./ * /Able to gather and assess information through interviews, observation, and documentation review./ * /Demonstrated ability to work independently and make sound decisions./ * /Solid understanding of regulatory requirements, policies, and procedures governing healthcare operations./ /*_Preferred Qualifications:_*/ * /Familiarity with methods for evaluating nursing practice and clinical performance./ * /Strong understanding of healthcare administration principles and operations./ * /Cultural competency and the ability to work effectively with individuals from diverse social, ethnic, and religious backgrounds./ /*_About the Lemuel Shattuck Hospital:_*/*/__/* Lemuel Shattuck Hospital is a fully Joint Commission accredited teaching facility that provides acute, subacute, and ambulatory care to patients referred by public agencies and private sector providers. Shattuck Hospital’s services help economically and socially disadvantaged patients to get high quality, cost-effective care from a staff that respects their dignity. Located in the heart of Boston’s Jamaica Plain neighborhood, the Shattuck Hospital includes 248 inpatient beds including 95 Psychiatric beds and 29 Correctional Health beds. In addition, the Shattuck has a full outpatient clinic with many specialties that offers treatment to patients of the Department of Mental Health as well as Department of Correction and House of Correction inmates and community patients. The Shattuck hospital is on the forefront of substance use disorder treatment including a Suboxone clinic serving 200 patients. In addition to direct medical services LSH hosts and supports an array of services located on the campus, serving patients struggling with addictions and homelessness. /*_Learn more about:_*//**/ what it’s like to work as a DPH nurse /*_Learn more about Shattuck Hospital:_*/https://www.mass.gov/locations/lemuel-shattuck-hospital /*_Relocation information_*//*:*/https://www.mass.gov/service-details/dph-renovation-for-shattuck-hospital-replacement-building /*_Pre-Hire Process:_*/*/__/* A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori*//* Education, licensure, and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines. Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth’s website, http://www.mass.gov If you require assistance with the application/interview process and would like to request an ADA accommodation, please click on the link and complete the Reasonable Accommodation Online Request Form For questions regarding this requisition, please contact Executive Office of Health and Human Services, Human Resources at 1-800- 510-4122 Ext. #4 *First consideration will be given to those applicants that apply within the first 14 days.* MINIMUM ENTRANCE REQUIREMENTS: Applicants must have at least (A) three years of full-time, or equivalent part-time, experience as a registered nurse in a recognized hospital, clinic or medical facility and (B) of which at least two years must have been in a supervisory, administrative, or managerial capacity, or (C) any equivalent combination of the required experience and the substitutions below. Substitutions: I. A Graduate degree with a major in Nursing may be substituted for a maximum of one year of the required (A) experience.* No substitutions will be allowed for the required (B) experience. *Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed. SPECIAL REQUIREMENTS FOR ALL LEVELS IN SERIES: Current and valid registration as a professional nurse under the Massachusetts Board of Registration in Nursing .* *Recent graduates from an approved school of nursing must have applied for the first available registered nurse examination. Special Requirements: Based on assignment, possession of a current and valid Massachusetts Motor Vehicle Operator's license may be required. Salary placement is determined by a combination of factors, including the candidate’s years of directly related experience and education, and alignment with our internal compensation structure as set forth by the Human Resources Division’s Hiring Guidelines. For all bargaining unit positions (non-management), compensation is subject to the salary provisions outlined in the applicable collective bargaining agreement and will apply to placement within the appropriate salary range _**_ _*Comprehensive Benefits*_ When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future. Want the specifics? Explore our Employee Benefits and Rewards! Title 101 CMR 23.00 (“Regulation”) requires certain agency staff to have received the COVID-19 vaccination and Influenza vaccination, or have taken required mitigation measures, to prevent viral infection and transmission in State Hospitals and State Congregate Care Facilities. The Regulation applies to this position. Successful candidates will be required to acknowledge and attest to your vaccination status for both COVID-19 and Influenza *An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.* The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role. **Job:** **Medical Services* **Organization:** **Department of Public Health* **Title:** *Director of Case Management - RN V* **Location:** *Massachusetts-Boston-170 Morton Street* **Requisition ID:** *25000533*