RN Case Manager Weekend Per Diem
4 weeks ago
As a RN Case Manager Weekend Per Diem at Hackensack Meridian Health, you will play a vital role in coordinating patient care activities to ensure that care meets evidence-based practice standards and regulatory/payer requirements. This role integrates and coordinates utilization management, care coordination, and discharge planning functions.
Responsibilities:
Facilitate the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement
Apply process improvement methodologies in evaluating outcomes of care
Coordinate communication with physicians, nursing, and staff of ancillary departments
Evaluate care provided against the Length of Stay
Collaborate with Admitting to ensure accuracy of patient demographic and insurance information
Communicate with patients and their families around medical plan of care and discharge plan
Assess and plan for discharge needs and arrangements, including leading multi-disciplinary care conferences and morning 'flash meetings' in conjunction with Nursing
Coordinates/facilitates patient care progression throughout the continuum
Completes utilization management for assigned patients
Manages all aspects of discharge planning for assigned patients
Quality-Actively participates in clinical performance improvement activities
Service a. Calls and communicates with major payors to discuss pitfalls and problem cases and documents interventions in Case Management IT system
Growth a. Uses Interqual Guidelines as a coaching tool to aid physicians /hospitalists in appropriate placement of patients Consults with Physician Advisor as appropriate
Adheres to the Medical Center's Organizational Competencies and the Standards of Behavior
Requirements:
Case Manager, Registered Nurse Graduate of a NLN/AACN accredited program in nursing a plus
Bachelor's degree in nursing (BSN) or 1 year experience for non BSN HackensackUMC employees
Excellent interpersonal communication and negotiation skills
Strong analytical, data management and PC skills
Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement
Understanding of pre-acute and post-acute venues of care and post-acute community resources
Strong organizational and time management skills, as evidenced by a capacity to prioritize multiple tasks and role components
Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families
Committed to scheduled weekend rotation to meet department needs
Commitment to rotate to evenings as required
Preferred Qualifications:
R.N. with at least 2 years clinical experience in the relevant clinical specialty (e.g., care managers for pediatric patients should have pediatric nursing experience) with a minimum of 2 of the 2 years in Case Management in an acute care setting
Certifications:
AHA Basic Health Care Life Support HCP Certification
NJ State Professional Registered Nurse License
Certified Case Manager
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