Case Manager RN Evangelical Days
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Job Location:
Lewisburg, OH - USA
Monthly Salary:
Not Disclosed
Posted on:
23 days ago
Vacancies:
1 Vacancy
Job Summary
Full-time (80 hours biweekly)
Weekdays daytime hours
Potential weekend coverage
General Summary
Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to facilitate a patients progression of care and the provision of appropriate cost effective and quality health care. Works in a team model with social work in assigned patient care areas to address patient discharge needs. Provides leadership in the integration of utilization and case management principles.
Responsibilities
Essential Functions:
- Reviews assigned patients for medical necessity utilization management and appropriateness of setting for continued hospitalization.
- Initiates problem-solving techniques to prevent over and/or under utilization.
- Facilitates and coordinates the progression of patient care to optimize throughput and the utilization of resources to support continuous quality and cost of care efforts.
- Liaisons between utilization management team third party payers and the treatment team regarding the identified treatment plan in accordance with contractual guidelines and System policy.
- Assists the patient care team with the identification and coordination of alternative treatment settings to provide appropriate care maintain quality of care and reduce cost.
- Identifies conditions which require case management across the care continuum. Collaborates with members of the patient care team to identify interdisciplinary needs
- Collaborates with care management across the system to effectively transition patient care and support value-based care initiatives.
- Completes case management patient assessment identifies needs develops a discharge plan and coordinates discharge needs (DME Home Health IV antibiotics etc.) in collaboration with patients families and care team.
- Assists with the collection and analysis of utilization patterns length of stay readmissions avoidable days and denied cases.
- Brings known or suspected problems of under- over- or inappropriate utilization of resources to the attention of the appropriate manager(s).
Common Expectations:
- Demonstrates a commitment to patient visitor and staff by complying with all applicable safety regulations learning the impact of medical errors and methodology that will lead to reduction of errors; reporting actual and potential errors as well as hazardous conditions; identifying opportunities to standardize processes and error proof systems that will lead to increased safety; and participating in safety education programs and root cause analyses as required.
- Prepares and maintains appropriate documentation as required.
- Maintains established policies and procedures objectives quality assessment and safety standards.
- Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
- Prepares and presents utilization data analysis as required.
- Participates in the development and delivery of educational information and process improvements related to job accountabilities and case management principles.
- Attends meetings as required.
Qualifications
Qualifications
Minimum Education:
- Associates Degree Required
- Bachelors Degree Preferred
Work Experience:
- 2 years Recent acute care experience Required
- Field of Experience in Utilization Management Case Management or Clinical Nursing Specialty. Preferred
Licenses:
- Licensed Registered Nurse Upon Hire Required or
- Registered Nurse Multi State License Upon Hire Required and
- Basic Life Support Upon Hire Required
- Certified in Case Management Preferred
Knowledge Skills and Abilities:
- Excellent interpersonal and communication skills.
- Basic computer skills.
- Desire and ability to work in a supportive and collaborative team environment.
Benefits Offered:
- Comprehensive health benefits
- Flexible spending and health savings accounts
- Retirement savings plan
- Paid time off (PTO)
- Short-term disability
- Education assistance
- Financial education and support including DailyPay
- Wellness and Wellbeing programs
- Caregiversupport via Wellthy
- Childcare referral service via Wellthy
For additional details: Benefits & Incentives WellSpan Careers ()
Required Experience:
Manager
Key Skills
- Project Portfolio Management
- Motivational Interviewing
- HIPAA
- Computer Skills
- Intake Experience
- Lean Six Sigma
- Conflict Management
- Case Management
- Team Management
- Program Development
- Social Work
- Addiction Counseling
About Company
WellSpan Health is a nationally recognized health system serving South Central Pennsylvania and northern Maryland.
