RN Care Coordinator/ Case Manager F/T days
The Care Coordinator supports the physician and multidisciplinary team at the Palisades Medical Center within the Hackensack Meridian Health (HMH) network in the provision of patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers. Integrates and coordinates utilization management, care facilitation and discharge planning functions.
1. Coordinates/facilitates patient care progression throughout the continuum. 2. Attends daily interdisciplinary rounds expedites and makes recommendations regarding medical necessity for admission, continued stay, or alternative treatment/facilities/agencies/resources. 3. Works collaboratively and maintains active communication with physicians, nursing and other members of the multidisciplinary team, appropriate patient management. 4. Addresses/resolves system problems impending diagnostic or treatment progress. 5. Identifies and resolves delays and obstacles to discharge on a proactive basis. 6. Consults with appropriate disciplines/departments as required to expedite care and facilitate discharge. 7. Utilizes advanced conflict resolution skills as necessary to ensure timely resolution of issues. 8. Collaborates with physician and all members of the multidisciplinary team to facilitate care for designated caseload; monitors the patientÂ¿s progress intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient; facilitates the following on a timely basis: a. Completion and reporting of diagnostic testing b. Completion of treatment plan and discharge plan c. Modification of plan of care, as necessary to meet the ongoing needs of the patient d. Communication to third-party payers and other relevant information to the care team e. Completion of all required documentation in patient records 9. Collaborates with physicians, physician assistants, physical therapists, social workers, nursing staff and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting. 10. Completes utilization management and quality screening for assigned patients. 11. Initiates case management intervention and applies InterQual acuity criteria to monitor appropriateness, within 24 hours or next working day of admission, and continued stays and documents findings based on department standards. 12. Manages disease processes utilizing evidence-based criteria and protocols. 13. Identifies at-risk populations using approved screening tool and follows established reporting procedures. 14. Monitors length of stay (LOS) and ancillary resources use on an ongoing basis. Takes actions to achieve continuous improvement in both areas. 15. Refers cases and issues to physician advisor in compliance with department procedures and follows up as indicated. 16. Communicates with resource center to facilitate covered day reimbursement certification for assigned patients. 17. Uses quality screens to identify adverse or potentially adverse issues and follows the quality protocol. 18. Ensures delivery of excellent customer service resulting in positive and improving patient satisfaction scores for department and Medical Center. 19. Other duties and/or projects as assigned. 20. Adheres to HMH Organizational competencies and standards of behavior.
Education, Knowledge, Skills and Abilities Required: 1. Registered nurse with a baccalaureate degree, from an accredited school or university or equivalent RN degree with commensurate clinical experience. 2. A minimum of four (4) years professional experience with two (2) years in acute care nursing. 3. Demonstrates a wide theory base and sound clinical skills to function as a nursing generalist. 4. Excellent verbal and written communication skills. 5. Ability to effectively communicate and resolve conflicts in a timely manner. 6. Detail-oriented and effectively manages time. 7. Ability to effectively collaborate with others. 8. Maintains clear and concise documentation. Education, Knowledge, Skills and Abilities Preferred: 1. Prior experience in clinical/utilization resource management activities and third party payer interaction. Licenses and Certifications Required: 1. Current RN licensure in the State of New Jersey. Licenses and Certifications Preferred: 1. Certified Case Management/Utilization Management.
As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.