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Inpatient Case Manager
4 months ago
POSITION SUMMARY:
Acts as an advocate for the patient, assisting them to reach optimal function and health in an appropriate environment that would support their needs. The Case Manager functions within the full scope of practice to include the major responsibilities of the position and to extend these responsibilities beyond the episode of care to encompass coordination of care across the continuum. The Case Manager applies the processes of assessment, planning, implementation, monitoring, evaluation, and coordination of care to meet the patients health care needs across the continuum in collaboration with health team members, community members, to ensure safe, quality and cost effective care.
ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:
Conducts assessments of patient/family needs by coordinating input from all health professionals and formulating a documented plan assuring continuity of care for the rising and high risk patients.
Delegates care coordination based on situation while assuming accountability for patient outcome. Supports assistive personnel; serves as a resource and holds assistive personnel accountable to complete delegated tasks.
Identifies appropriate providers, facilities, external healthcare organizations throughout the continuum of care and communicates with an interdisciplinary treatment team to develop and maintain positive working relationships with patients, families and providers.
Functions as a coordinator and manager of a defined health population across care setting and for multiple physicians/health care providers or health plan counterparts. Works closely with their assigned primary care department/practice to offer individualized assistance with improving and maintaining quality patient care.
Coordinates care across the continuum (inpatient/outpatient/community) to assure appropriate utilization of clinical and community resources.
Oversees and guides the development of multiple health partnerships to achieve a positive health effect.
Participates on a team for data collection, health outcomes reporting, clinical audits, and programmatic evaluation related to initiatives.
In conjunction with the practice team, identifies patients at risk for poor outcomes or experiencing poor coordination of services who would benefit from more intensive follow-up.
Provides chronic disease and self-management education and support.
SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:
Assist in coordination of the development of practice parameters with the assigned departments/sections/specialties of Medical Staff.
Identifies professional needs to maintain expertise and keep current with health care trends, both clinical and financial.
Serves on committees and actively participates in department staff meetings and performance improvement activities, using the gained knowledge through lean six-sigma training.
Helps in identification of best methods to transmit case management plan to all points of care provided in the health care system, and county social service agencies.
Actively engages in educational activities with Medical Students and Residents.
Participates in the on-call responsibilities for this position as required.
Other duties as assigned.
JOB REQUIREMENTS
MINIMUM REQUIRED QUALIFICATIONS:
RN or Social Worker is required for this role, with specific requirements being one of the following:
RN:
- Current licensure as a Registered Nurse, issued by the Pennsylvania Board of Nursing.
- Bachelors degree in Nursing (BSN) or a related health care degree is required OR RN with at least ten years acute/subacute care or CM experience.
Social Worker:
Masters degree in Social Work (MSW) or a Bachelor's degree in Social Work (BSW) with a Master's degree (MS) in Human Services from an accredited school or program OR Bachelors degree in Social Work with ten years relevant experience.
Three years of acute care nursing or social work experience.
Excellent verbal and written communication skills.
Excellent customer service skills.
Proven informal leadership skills.
Ability to work independently, setting priorities to coordinate care plans efficiently.
Ability to work effectively in a fast-paced team environment.
Highly organized and detail-oriented with the ability to perform multiple tasks simultaneously.
Effective behavioral and educational strategies, including, but not limited to: motivational interviewing, teach-back method and self-management support.
One year experience in case coordination and planning as well as experience in project implementation and execution.
Demonstrated experience successfully working among multi-disciplinary teams.
PREFERRED QUALIFICATIONS:
Five years of case management experience.
Case Management certification (ACM/CCM) within 3 years.
Current Licensure as a RN, issued by the Pennsylvania Board of Nursing.
Bachelors degree in Nursing (BSN).
Knowledge of utilization review or managed care.
Care management experience in a managed care setting.
This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards. The percentages of time spent performing job duties are estimates, and should not be considered absolute. The incumbent shall perform all other functions and/or be cross-trained as shall be determined at the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole. Incumbent must be able to perform all job functions safely. #LI-LJ1
Benefits At A Glance:
PENN MEDICINE LANCASTER GENERAL HEALTH offers the following benefits to employees:
% Tuition Assistance at The Pennsylvania College of Health Sciences Paid Time Off and Paid Holidays Shift, Weekend and On-Call Differentials Health, Dental and Vision Coverage Short-Term and Long-Term Disability Retirement Savings Account with Company Matching Child Care Subsidies Onsite Gym and Fitness ClassesDisclaimer
PENN MEDICINE LANCASTER GENERAL HEALTHis an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion or any other classification protected by law.
