ED Care Manager (RN) - Days - Part Time - Benefit Eligible

CentraState Healthcare System•Freehold, NJ

10d

About The Position

Emergency Department (ED) Nurse Care Manager is responsible for establishing, coordinating, and maintaining the process to optimize patient throughput to the most appropriate level of care while facilitating interdisciplinary care across the continuum. The Nurse Care Manager collaborates with the patient/family, multidisciplinary team, physicians, community resources and payers to ensure the patient’s progress and level of care is appropriately determined for the emergency episode of care and for the encounter to ensure that care is performed in the right level of care and facilitated in an efficient and cost-effective manner.

Requirements

Graduate from an accredited school of nursing - BSN preferred.
RN NJ licensed required.
Prior clinical experience in care and management of hospitalized patients required.
Experience in acute care utilization preferred.
Utilization review or case management training from a professional case management organization preferred.
Data and computer skills

Nice To Haves

Case Management certification preferred.

Responsibilities

Level of Care Determination: Completes initial medical necessity review on all ED patients with potential for admission, works with providers to identify appropriate level of care designation. Documents in accordance with established policy and procedure. Educates ED physicians and nurses about medical necessity/admission criteria and e nsures documentation matches patient's clinical condition.
Implements Actions to Prevent Readmission: Collaborates with medical staff to recommend referrals for outpatient care, home health or other community agencies as indicated. Provides post-discharge follow-up by conducting or delegating the telephone evaluation of discharge plan.
Participates in frequent utilizer measures : W orks to establish interventions to manage high hospital and ED utilizers.
Initiates discharge planning: Conducts screenings for social determinants of health and initial discharge planning assessments for patients admitted through the emergency department. Refers when necessary to Social Worker.
Supports patient flow: Intervenes to expedite the completion of diagnostic tests needed to determine disposition, offers alternatives to admission when appropriate, engages in boarder rounds to determine any needed changes in disposition.
Maintains knowledge of Federal, State, and other regulatory agency rules and regulations : Including The Joint Commission, CMS, Medicare, including but not limited to, knowledge of CMS rules regarding Observation status, the 2 Midnight Rule, and Medicare Inpatient Only Procedures.
Maintains knowledge of continuum of cares resources: Provides education and resources relevant to the effective progression of care, utilization of services, appropriate level of care, and safe patient transition to the patient/family and health care team.
Identifies potential risk management and/or quality issues: Works with the healthcare team to resolve such issues or refer them through the Chain of Command structure to the appropriate resource/committee
Reduce 30-day readmission rates
Improve post-discharge care coordination
Enhance medication safety and adherence
Connect patients to primary and specialty care
Address social determinants of health (SDOH)
Ensure timely post-discharge follow-up
Reviews medications for safety, duplication, adherence, access and affordability.
Coordinates follow-up visits with PCP or Specialist before discharge.
Assures continuity of care with the sharing of discharge summary with patient’s care providers.
Links patients to Home Health, Hospice, Post-acute care and Community Resources.

Benefits

Medical, Dental, Vision, Prescription Coverage (30 hours per week or above for full-time and part-time team members)
Life & AD&D Insurance
Long-Term Disability (with options to supplement)
403(b) Retirement Plan with employer match
401(a) Retirement Plan with employer contribution
PTO
Tuition Reimbursement
Well-Being Rewards
Employee Assistance Program (EAP)
Fertility Coverage, Healthy Pregnancy Program
Flexible Spending & Commuter Accounts
Pet, Home & Auto, Identity Theft and Legal Insurance
Growth Opportunity and Workforce Development Initiatives
Continuing Education / Onsite Training
Concierge Services with Work & Family Benefits