RN Acute Case Manager - System Care Management - Per Diem

Guthrie Health • Troy, PA

29d

About The Position

The Acute Case Manager utilizes industry accepted processes for achieving optimal patient, clinical, and operational outcomes timely, coordinated, and in cost effective manners. The Acute Case Manager has the responsibility, accountability, and authority for coordinating the medical management of hospital patients, using outcomes-based approaches. The Acute Case Manager supports the healthcare team in assessing, planning, and facilitating individualized continuum of care plan for patients, based on assessed needs and available resources. The Acute Case Manager monitors clinical approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with other internal and external offices, payors, and providers. The Acute Case Manager collaborates cooperatively with the patient and members of the interdisciplinary health care team. The Acute Case Manager takes a proactive approach to ensuring the integration of both clinical and operational outcomes through analysis of clinical and financial data, including length of stay and DRG profiling.

Requirements

• RN Bachelor of Science degree in Nursing (BSN) or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or BA degree will be considered. Must obtain BSN within two (2) years of hire. Individual consideration may be given to a registered nurse, with significant clinical experience, who holds a bachelor's degree in a related field.
• BSN or BA with a minimum of five (5) years relevant experience who demonstrates leadership and autonomy in nursing practice. a) Utilize critical thinking skills to create and or develop a clinical program or position and b) Demonstrated leadership skills for a licensed degree exception, there must be a significant depth of clinical experience: five (5) years of experience in an acute care setting with strong care management, utilization review, and payer knowledge.

Nice To Haves

• A Case Management certification or obtaining a Case Management certification within one (1) year of eligibility is encouraged.

Responsibilities

• The Acute Case Manager collaborates to support that the right care is provided to patients in the right setting with a broad spectrum of health and community providers.
• Coordinates medical management through ongoing interaction with the patient and family/caregivers, physician and other health care providers to achieve designated clinical, operational and financial outcomes.
• Identifies individual patient discharge needs in collaboration with other clinical team members beginning upon initial admission assessment and continued reassessment throughout an episode of care. Takes the initiative in working with the interdisciplinary health care team and patient/family to identify a treatment regime which streamlines care, reduces or controls costs and enhances patient outcomes.
• Integrates patient information, clinical/financial/operational data and evaluates the impact upon patient, clinical, and financial outcomes. Identifies opportunities to continue or reduce costs and optimize case reimbursement.
• Demonstrates leadership skills including effective written and verbal communication, conflict resolution, problem solving and critical thinking, organizational and time management skills and appropriate delegation.
• Participates in performance improvement and educational activities.
• Validates authorization/certification process for elective short procedures and urgent inpatient care services in collaboration with physician offices and other hospital departments as appropriate.

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level
• Industry: Religious, Grantmaking, Civic, Professional, and Similar Organizations
• Number of Employees: 5,001-10,000 employees