Nursing Jobs in Brimfield, MA
$130,977 - $178,048 / year
Baystate Health, a nationally recognized leader in healthcare quality and safety, and home to Baystate Medical Center (BMC), a Magnet Hospital for Nursing Excellence is looking for an Pediatric Intensive Care Unit Nurse Manager! Clinical Practice and Quality Outcomes: The Nurse Manager is accountable for ensuring excellence in the clinical practice of nursing and the delivery of patient- and family-centered care. Delivers on our organizational service excellence promise in all unit practices and programs, as evidenced by relevant metrics. Provides leadership in proactively developing quality driven, cost effective improvement initiatives. Collaborates and partners with members of interdisciplinary team to achieve outcomes in performance improvement efforts. Human Resource Leadership: The Nurse Manager leads a positive work environment that facilitates the delivery of excellent patient and caregiver experiences. Staff are highly engaged, as evidenced by relevant metrics. Individual and collective practices reflect the core principles of Magnet. Initiates and manages necessary change, providing support and resources to staff. Seeks opportunities to build working alliances with other professional groups. Creates opportunities for shared governance in order to effectively solve probems. Fosters learning and professional growth opportunities for all staff. Communicates and holds staff accountable to clear performance expectations. Establishes staffing plans that respond to changing needs of the unit. Management of the Patient Care Environment: The Nurse Manager is a leader who is highly visible on the patient care unit and is responsible for the effective management of patient progress and outcomes of care. Leads collaborative efforts with other departments and disciplines to meet patient care needs. Accountable for unit issues, including the adequacy of appropriate materials and equipment, until resolution occurs. Financial Growth and Stewardship: The Nurse Manager is accountable to manage within budget as evidenced by metrics. Stewards financial resources and promotes growth by developing business plans and budget for their unit per organizational goals and other relevant factors. Establishes expectations with and holds accountable staff regarding the delivery of high quality, affordable care. Responds to budget variances in a proactive, timely manner. Operational Planning: The Nurse Manager, in concert with nursing and medical director, sets a progressive pace for performance improvement and. based on assessment of internal and external influences. creates and implements plans that have a positive impact on the delivery of patient care and a positive work environment. DEPARTMENT DESCRIPTION: 7 bed Pediatric and Intensive Care Unit We are the region’s only Pediatric Intensive Care Unit, we provide advanced medical, surgical, and trauma care for infants, children, and young adults through age 21 Our PICU has been newly redesigned and has seven private rooms with glass doors we can close to increase privacy while still allowing the staff to visually monitor patients Patients in the PICU are monitored by state-of-the-art heart and breathing equipment, and all the equipment is designed specifically for the needs of childre SCHEDULE: Full Time, 5, 8hr shifts Mon - Friday Location: Baystate Medical Center Springfield THE ADVANTAGES OF WORKING WITH BAYSTATE! Excellent Compensation High-quality, low-cost medical, dental and vision insurance Pet, home, auto and personal insurance Certification and continuing education reimbursement Nursing forgivable loan program 403b retirement company match & annual company contribution increase based on years of service Life insurance First time homebuyer program Free money coach advice from a certified professional Reimbursement for a variety of wellbeing activities, included but limited to: gym membership and equipment, personal trainer, massage and so much more! Wellbeing programs that include but are not limited to mental, physical, and financial health QUALIFICATIONS: Successfully passed Board of Registration in Nursing Examination and is licensed in the Commonwealth of Massachusetts Current American Heart Association Health Care Provider CPR certification required. Experience: Minimum 5 years of nursing in related setting Education: Bachelors Degree in Nursing required We strive to be the place where we can help you build the career you deserve – apply today – YOU belong at Baystate! Our compensation philosophy We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above considers the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role. Education: Bachelors Degree (Required) Certifications: Certified Registered Nurse - OtherOtherOther, Registered Nurse - State of MassachusettsState of MassachusettsState of Massachusetts Compensation Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees. Minimum - Midpoint - Maximum $130,977.00 - $150,550.00 - $178,048.00 Equal Employment Opportunity Employer Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status. 
$110,000 - $115,000 / year
Overview About us: Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief summary of purpose: The Clinical Documentation Review RN is responsible for auditing care plans, health risk assessments, MDS assessments and other clinical documentation to ensure accuracy, completeness, and compliance. This role supports quality of care and regulatory adherence by reviewing documentation against CMS and state contractual guidelines. The reviewer provides feedback and guidance to clinical teams to promote accurate, consistent and compliant documentation that reflects the member’s health status and care needs. Responsibilities Primary Job Responsibilities: Audits documentation ensuring documentation meets quality standards and interventions and actions are effective to meet member needs Conduct audits of medical records to verify that documentation supports the services provided, meets regulatory standards, and aligns with SCO program requirements. Ensure interdisciplinary care plans are updated and reflect current member needs and are in compliance with regulatory and accreditation requirements. Confirm that assessments are documented and integrated into care planning. Audit MDS-HC forms entered into the State’s System to ensure compliance with current Supplemental Instructions Audit documentation for evidence of care coordination across medical, behavioral health, and long-term services. Ensure transitions of care (e.g., hospital discharge) are documented with follow-up plans and communication between providers. Identify documentation gaps that may impact care coordination, reimbursement, or compliance with MassHealth, CMS, and SCO-specific guidelines. Collaborate with providers and care teams to clarify clinical documentation through queries and feedback, ensuring accurate reflection of patient acuity, diagnoses, and care plans. Monitor trends and patterns in documentation errors or omissions and recommend corrective actions or process improvements. Educate clinical staff on best practices for documentation, including SCO-specific standards, regulatory updates, and audit findings. Participate in interdisciplinary and team meetings to provide insight into documentation quality and contribute to care planning and compliance strategies. Maintain audit logs and reports to track findings, follow-up actions, and performance metrics related to documentation quality and integrity. Collaborate with departments throughout Fallon to ensure documentation aligns with company policies and procedures. Qualifications Education: Graduate from an accredited school of nursing mandatory and a Bachelors (or advanced) degree in nursing or a health care related field preferred License/Certifications: License: Active, unrestricted license as a Registered Nurse in Massachusetts Certification : Certification in Case Management preferred Other: Satisfactory Criminal Offender Record Information (CORI) results, reliable transportation Experience: 4+ years job experience as a Registered Nurse working in a care management/care coordination role in a managed care payor operating a dual Special Needs Plan required. Experience with NCQA, CMS, and other required regulatory requirements and experience writing and developing policies and process documents required. Experience with developing audit tools, auditing team member performance, and working with staff to improve their performance preferred. Demonstrated proficiency including but not limited to: Ability to develop a system and process to objectively measure care management competencies and to hold team members accountable, including, but not limited to developing corrective action plans, as appropriate Ability to identify gaps in staff’s knowledge base and to design training materials to address those gaps Ability to teach others in an organized and structured manner utilizing adult learning principles and collaboration skills Advanced skills in software systems including but not limited to Microsoft Office Products – Excel, Outlook, and Word Manipulation of Excel spreadsheets to manage work and exposure and familiarity with pivot tables desirable Working with an interdisciplinary care team as a partner demonstrating respect and value for all roles and is a positive contributor within job role scope and duties Knowledgeable about medical record documentation Critical thinking skills for independent problem solving Prior experience with clinical documentation review, quality audits, or utilization review preferred. Familiarity with chronic disease management, care planning and transitions of care. Experience with Minimum Data Set- Home Care assessments and requirements associated with such. Access and ability to navigate the State’s Virtual Gateway platform for MDS-HC review and submission Excellent attention to detail, analytical skills, and ability to identify discrepancies in documentation. Proficiency with EMR systems and audit tools. Strong written and verbal communication skills; ability to provide constructive feedback to clinical staff. Strong knowledge and understanding of current State Supplemental Instructions for MDS-HC submission for rating category assignment Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $110,000 - $115,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. . Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. 
$98,051 - $133,348 / year
RN Case Manager Full Time - 40 Hours The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that will ensure continuity and effective community or post acute reentry. The Hospital Case Manager leads the interdisciplinary team in developing complex discharge plans. Responsibilities: Facilitates patients care plan as called for in the plan of care Leads daily patient care huddles with nursing to direct timely progress along the continuum Works cooperatively as a leading member of the health care team to insure appropriate use of hospital resources, patient satisfaction, and achievement of quality of care. Manages input from all health care professionals and conducts assessments to determine patients health care and transitional needs. Su Evaluates and ensures appropriateness of admissions and continued stay using evidence based criteria Collaborates and manages outcomes with the payers through ongoing written and verbal communications to appropriate parties Leads discussions with Physician advisors and MD's about safe plan for transitions Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate Collaborates with community case managers and other health care advisors to ensure a smooth and safe continuum of care plan Conducts extensive assessments and implements interventions for patients at risk for readmissions Manages concurrent denials and works with physicians to overturn for appropriate reimbursement Required Work Experience: BSN Required 3-5 years clinical Nursing experience Hospital Case Management, Care Coordination experience strongly preferred Skills and Competencies: Requires a working knowledge of community resources and Utilization/Quality Review standards and activities conducted by third party payers Ability to organize and prioritize workload in order to meet deadlines Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third party payers where appropriate Excellent computer skills Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third party payers where appropriate There is a weekend and holiday commitment. THE ADVANTAGES OF WORKING WITH BAYSTATE! Excellent Compensation High-quality, low-cost medical, dental and vision insurance Pet, home, auto and personal insurance Certification and continuing education reimbursement 403b retirement company match & annual company contribution increase based on years of service Life insurance Free money coach advice from a certified professional Reimbursement for a variety of wellbeing activities, included but limited to: gym membership and equipment, personal trainer, massage and so much more! Wellbeing programs that include but are not limited to mental, physical, and financial health Our Compensation Philosophy We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above considers the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role. Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees. Minimum - Midpoint - Maximum $98,051.00 - $112,715.00 - $133,348.00 Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status. 
