The Case Manager is responsible for utilizing advanced nursing skills in the assessment and planning of clinical care for an identified group of patients. Collaborates with the Attending, Resident, and Intern medical staff as well as Resource Planning, Nursing, ancillary, professional, and technical staff to coordinate the delivery of high quality, individualized, cost-effective patient care. Performs appropriate Utilization Review functions utilizing approved Intensity of Service, Severity of Illness criteria. Coordinates utilization management and evaluates services provided. Oversight responsibilities of the Resource Planner includes delegation and supervision of daily work assignments, education of the discharge planning process, and identification of barriers to discharge/transfers. Concurrently intervenes to enhance patient quality outcomes where appropriate. Brings support to the performance improvement process by comprehensive analysis of patterns and trends. Acts as a consultant to the Care Coordination team, clinical team, and other departments.
RN required, BSN required, MSN Preferred. Minimum of three years of acute hospital experience; or the equivalent of education and experience. Pediatric experience preferred. Official Transcripts and/or original diploma from a registered nursing program must be provided upon hire.
Demonstrates resourcefulness, effective written and oral communication, diplomacy, organizational, and analytical skills (Required).
Recent experience in case management, utilization management, or discharge planning.
Team leading or management experience.
Self-directed, assertive and creative in problem solving, systems planning and patient care management in a high volume work environment.
Ability to work effectively and collaboratively with interdisciplinary teams.
Basic working knowledge of a large University teaching hospital; its purpose and functions.