17 days old

362610 Case Manager RN

Penn Medicine
Plainsboro, NJ 08536
Penn Medicine is seeking an RN Case Manager to join the team. This position is located in Plainsboro, NJPOSITION SUMMARY¢\tThe Case Manager supports the interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers. The role integrates and coordinates utilization management, care facilitation and discharge planning functions. In addition, the Case Manager helps drive change by identifying areas where performance improvement in needed (e.g., day to day workflow, education, process improvements, patient satisfaction).ESSENTIAL JOB DUTIES AND RESPONSIBILITIES1.\tWorks collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient management.2.\tAddresses/resolves system problems impeding diagnostic or treatment progress. Proactively identifies and resolves delays and obstacles to discharge.3.\tApplies approved clinical appropriateness criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Department standards.4.\tEnsures that all elements critical to the plan of care have been communicated to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care.5.\tMeets directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with physician.6.\tDocuments relevant discharge planning information in the medical record according to Department standards.7.\tCollaborates and communicates with multidisciplinary team in all phases of discharge planning process, including initial patient assessment, planning, implementation, interdisciplinary collaboration, teaching and ongoing evaluation.8.\tRefers appropriate cases for social work intervention based on Department criteria.9.\tInitiates and facilitates referrals for home health care, hospice, medical equipment and supplies.10.\tCollects delay and other data for specific performance and/or outcome indicators, including but not limited to Avoidable Days, as determined by Director/Manager.11.\tPromotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.12.\tCommunicates relevant clinical information, including admission review, concurrent review, and discharge planning needs, to third party payors to secure optimal reimbursement.OTHER JOB DUTIES AND RESPONSIBILITIES¢\tThe Case Manager will:1.\tFollow 100% of assigned inpatient admissions;2.\tDetermine the medical appropriateness of the patients admission (severity of illness);3.\tMonitor the plan of care and proactively identify barriers to the plan (intensity of service);4.\tIntervene to avoid delays in plan of care;5.\tIdentify trends in inappropriate utilization due to delays in diagnostic testing, medical and surgical procedures, and physician management;6.\tCoordinate flow of clinical information with third party payors to ensure appropriate reimbursement, proactively identify potential denials in order to avoid non-appealable denials;

QUALIFICATIONS\nEducation\n•\tBSN degree required\n\nRelated Work Experience\n•\tMinimum of 3 years Medical-Surgical experience required; Case Management and Discharge Planning experience preferred.\n\n\nLICENSURE, CERTIFICATION OR REGISTRATION REQUIREMENTS\n•\tState of New Jersey Registered Nurse license required.\n•\tNational Case Management certification preferred; or obtained within two years of employment.\nSPECIALIZED SKILLS & KNOWLEDGE REQUIREMENTS\n•\tExcellent interpersonal, verbal and written communication skills.\n•\tExcellent critical thinking skills.\n•\tExcellent organization and analytical skills.\n•\tKnowledge and understanding of computer systems and software applications.\n•\tAbility to work with all age groups and populations.

Categories

Posted: 2021-05-25 Expires: 2021-06-24

Share this job:

362610 Case Manager RN

Penn Medicine
Plainsboro, NJ 08536

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast