About The Position

The position involves conducting complete assessments, establishing appropriate plans, and initiating interventions within desired timeframes. The role requires effective collaboration and negotiation with patients, families, and the healthcare team to achieve patient and organizational goals regarding care needs, choice, and satisfaction during discharge planning and transitioning care. The case manager will utilize patient and family strengths in the problem-solving process, involving them in decision-making from admission through the patient's hospital stay. Responsibilities include providing continuity of care and discharge planning services compliant with regulatory standards, managing family dynamics and crisis situations, and educating patients and families about accessing services. The position also involves documenting discharge planning interventions, performing concurrent and retrospective reviews, and communicating effectively with the healthcare team. The case manager will work closely with social work and unlicensed support personnel, participate in multidisciplinary teams, and collaborate with various stakeholders to resolve barriers to discharge and expedite care delivery. Knowledge of healthcare regulations, reimbursement issues, and community resources is essential. The role requires the ability to prioritize work, effective communication skills, and knowledge of Medicare guidelines and managed care program requirements.

Requirements

  • Registered Nurse License issued by the state of practice.
  • Bachelor’s Degree in Nursing.
  • 2 years of clinical nursing experience.
  • Ability to prioritize and organize work.
  • Effective communication skills.
  • Utilization of critical thinking and timely decision making.
  • Ability to navigate the Electronic Health Record.
  • Basic utilization of MS Office products.
  • Knowledge of Medicare A and B guidelines.
  • Knowledge of Managed Care program requirements.

Responsibilities

  • Conduct complete assessments and establish appropriate care plans.
  • Collaborate with patients, families, and the healthcare team to achieve care goals.
  • Utilize patient/family strengths in the problem-solving process.
  • Provide continuity of care and discharge planning services compliant with regulatory standards.
  • Manage family dynamics and crisis situations using community resources.
  • Document discharge planning interventions and utilization review activities.
  • Communicate effectively with the healthcare team.
  • Work in partnership with social work and support personnel.
  • Participate in multidisciplinary teams to identify and resolve discharge barriers.
  • Collaborate with managers and physicians on best practices for patient care.
  • Complete utilization management activities and deliver CMS regulatory notices.
  • Develop relationships with community-based agencies to meet patient needs.

Benefits

  • Paid Time Off programs.
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability.
  • Flexible Spending Accounts for eligible health care and dependent care expenses.
  • Family benefits such as adoption assistance and paid parental leave.
  • Defined contribution retirement plans with employer match.
  • Educational Assistance Program.

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What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Education Level

Bachelor's degree

Number of Employees

11-50 employees

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