Case Manager, BSN- Care Coordination, Per Diem, Vineland

Inspira Health

105d

About The Position

Facilitates a patient’s hospitalization from pre-admission through discharge. Collaborates with physicians, nurses, social workers and other members of the healthcare continuum to ensure appropriate, cost-effective care. Applies clinical expertise and medical necessity criteria to perform the functions of utilization management, care coordination, resource utilization, and discharge planning. Must utilize established criteria to review appropriateness of admission and continued stay. Perform initial and ongoing assessment to ensure a timely transitional care plan is developed that will support each patient’s needs and prevent hospital readmission. Identify and prevent potential barriers in transition of care. Ensure discharge plan is consistent with patient’s clinical course, continuing care needs, and covered services. Identify patients and/or families who require social work referral. Actively participate in multidisciplinary rounds. Collaborate with next level of care providers as appropriate.

Requirements

• BSN required if hired after September 1, 2021.
• For Mannington only, BSN required for hires after June 1, 2023, or must enroll in a BSN program within 6 months.
• Minimum 3 years of experience in a hospital setting required.
• 1-3 years of case management experience preferred.
• Clinical background in assigned unit/service line preferred.
• Previous utilization management experience preferred.
• Previous experience with regulatory and compliance requirements preferred.
• Licensed Registered Nurse in New Jersey required.
• Case Management Certification preferred.

Nice To Haves

• Excellent communication skills (oral and written).
• Excellent clinical and administrative skills and judgement.
• Proficiency in Microsoft Office.
• Ability to work independently and set priorities.
• Working knowledge of Milliman criteria preferred.

Responsibilities

• Facilitates patient hospitalization from pre-admission through discharge.
• Collaborates with healthcare team members to ensure appropriate care.
• Applies clinical expertise for utilization management and care coordination.
• Performs initial and ongoing assessments for transitional care planning.
• Identifies and prevents barriers in transition of care.
• Ensures discharge plan aligns with clinical course and care needs.
• Identifies patients/families needing social work referral.
• Participates in multidisciplinary rounds.
• Collaborates with next level of care providers.

Benefits

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What This Job Offers

• Education Level: Bachelor's degree