The Nurse Case Manager organizes all necessary healthcare services to promote child-centered and family-centered outcomes that will facilitate the highest possible quality of life for each patient. The Nurse Case Manager is responsible for facilitating and coordinating the clinical, financial and psychosocial aspects of admission and discharge; planning for patients admitted to Blythedale’s inpatient service and residents admitted to the Steven and Alexandra Cohen Long Term Care Pavilion (LTC). Through collaboration with the referring hospital, medical care team, social worker, patient/family educators, therapists, and other disciplines, they ensure timely and accurate transfer of information from the referring hospital to the care team and prepare for all aspects of the safe admission and discharge of patients. They are responsible for addressing the holistic needs of the patient or resident including medical support, education, caregiver training, ongoing rehabilitation, equipment, and behavioral health support. The Nurse Case Manager is the first point of contact for patients and their families following referral to Blythedale. They will participate in family tours and help set family expectations when transitioning from acute care. They continue to support them with planning and preparing for discharge. The Nurse Case Manager makes referrals to homecare agencies, DME suppliers, outpatient therapy sites, health homes, and long-term care facilities as recommended by the treatment team and in consultation with the family. Services are determined by patient/resident/family choice and the Nurse Case Manager will provide support in understanding what is possible under the patient/resident’s insurance(s) and in their geographic area. They will collaborate with the patient/resident’s providers as necessary to support continued stay or advocate for discharge needs.
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Job Type
Full-time
Career Level
Mid Level