Clinical Case Manager

4 weeks ago


Philadelphia, Pennsylvania, United States Children's Hospital of Philadelphia Full time

Seeking a Dedicated Case Manager

Children's Hospital of Philadelphia (CHOP) is committed to providing exceptional care to our patients and families. We are seeking a highly skilled and compassionate Registered Nurse to join our team as a Clinical Case Manager - Inpatient. This role will play a critical part in ensuring the seamless transition of patients from hospital to home, while also promoting efficient and effective use of healthcare resources.

Key Responsibilities:

  • Determine medical necessity and appropriateness of admission, continuing stay, and level of care using clinical information, clinical criteria, and third-party information.
  • Collaborate with multidisciplinary teams to develop and implement effective discharge plans, ensuring patients receive the necessary support and resources for a successful transition.
  • Validate admission and continuing stay criteria with third-party payers and attending physicians, recommending alternative care sites when necessary.
  • Support the prevention and management of denials, providing requested information as part of the appeal process.
  • Assess patients and families for continuing care needs, developing and implementing effective discharge plans in collaboration with the multidisciplinary team.

Requirements:

  • At least five years of experience as a Registered Nurse, with a focus on case management or discharge planning.
  • Previous experience in a pediatric setting or similar adult setting is preferred.
  • Excellent communication and organizational skills, with the ability to work effectively with all departments and levels of CHOP professionals.

What We Offer:

  • A competitive salary and benefits package.
  • Opportunities for professional growth and development, including education and training programs.
  • A collaborative and supportive work environment, with a focus on teamwork and patient-centered care.

How to Apply:

If you are a motivated and compassionate Registered Nurse looking to make a difference in the lives of our patients and families, please submit your application today.



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