RN Case Manager

5 days ago


Wilmington, Delaware, United States ChristianaCare Full time
Job Summary

ChristianaCare is seeking a skilled RN Case Manager to coordinate the utilization of healthcare resources and facilitate the achievement of clinical, quality, financial, and member satisfaction goals in our Maternity Care Coordination program.

Key Responsibilities
  • Coordinate the utilization of healthcare resources, including transition planning, to ensure optimal patient outcomes.
  • Collaborate with patients, caregivers, and members of the multi-disciplinary care team to develop a member-centered plan of care to meet identified member care goals and outcomes.
  • Develop, implement, evaluate, and revise case management care plans according to case management eligibility criteria, contractual guidelines, and members' physical and psychological needs throughout the continuum of care.
  • Identify system issues that serve as barriers to care and participate in the development and implementation of strategies to remove barriers and promote resolution through the coordination of a problem-solving process.
  • Promote member wellness and autonomy through advocacy, communication, education, and identification and referral to community resources or other case management programs.
  • Collaborate with transitional, embedded, and inpatient case managers in the discharge and transitional care process, obtaining and/or coordinating appropriate resources for members throughout the continuum of care.
  • Stratify and/or validate member's level of risk during each transition process and interaction with the member.
  • Collaborate with healthcare providers in settings not limited to the PCP office, hospital, skilled nursing facility, or home care agencies to assist members in coordinating safe care.
Requirements
  • DE RN License or Compact Nursing License
  • BSN is required or a commitment to obtain within 3 years of the hire date.
  • 2-5 years relevant experience in Utilization Management or Case Management.
  • The ability to obtain a non-compact state RN Licensure as needed.
  • Active Basic Life Support (BLS) certification
  • Case Management Certification is preferred through the Commission for Case Management (CCM) within 18 months of eligibility.
  • Advanced Certification is recommended.
Physical Demands

The ability to ambulate within an office setting, occasional sitting, standing, and lifting loads of 5-10 pounds.


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