RN Case Manager - Utilization Management (Per Diem)

Hartford HealthcareWillimantic, CT
14h

About The Position

Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common\: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. For more than 75 years, Windham Hospital has treated patients with the latest high-tech equipment, operated by some of the most skilled and compassionate medical professionals available. We seek to meet the total healthcare needs of people from throughout Northeastern Connecticut. Our staff members are proud to live and work in this area and are committed to providing quality healthcare to our community. Position Summary Provides guidance and/or direction in the management of overall discharge planning and appropriate use of hospital resources. Works under the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians, social services, and other hospital personnel. Assesses the need for and facilitates the delivery of post hospital care for neonates, infants, pediatric, adolescent, adult and geriatric patient populations by making the necessary referrals to home care agencies or to SNF/Subacute facilities. Evaluates the appropriateness of hospital services. Ensures that patients receive the appropriate services at the appropriate time to promote quality outcomes at a reasonable cost. Maintains a program of admission and continued stay certification for Medicare, Medicaid and HMO review.

Requirements

  • Three years clinical nursing required.
  • Two years experience with case management, discharge planning, utilization review and/or home care required.
  • Knowledge of the management of patients along the continuum of care required.
  • Current license as a registered nurse in the State of Connecticut.
  • Registered nurse with current licensure in the State of Connecticut.
  • Bachelor's degree required, preferably in nursing (equivalencies may be considered based upon experience and qualifications).
  • Ability to utilize Microsoft Office strongly preferred.

Nice To Haves

  • Case management experience preferred.
  • Certification in Case Management or Utilization Management is preferred.
  • Experience with MIDAS software a plus.

Responsibilities

  • Provides guidance and/or direction in the management of overall discharge planning and appropriate use of hospital resources.
  • Works under the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians, social services, and other hospital personnel.
  • Assesses the need for and facilitates the delivery of post hospital care for neonates, infants, pediatric, adolescent, adult and geriatric patient populations by making the necessary referrals to home care agencies or to SNF/Subacute facilities.
  • Evaluates the appropriateness of hospital services.
  • Ensures that patients receive the appropriate services at the appropriate time to promote quality outcomes at a reasonable cost.
  • Maintains a program of admission and continued stay certification for Medicare, Medicaid and HMO review.
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