University of Maryland Medical Center – Baltimore, MD
Schedule: Full-time Day Shift (M-F 8am-4pm, occasional weekends)
What You Will Do:
Under general supervision of the Manager of Case Management, the Case Manager provides care coordination and discharge planning for an assigned patient case load. The Case Manager will assess individual patient’s needs, coordinate and implement plans of care and monitor and evaluate outcomes across the continuum of care.
Principal Responsibilities and Tasks
Assesses assigned patients and integrates psycho social assessment within the multidisciplinary team. Works collaboratively with the multi-disciplinary team to determine potential and actual risks to recovery and formulates plan to determine appropriate level of care upon disposition from the acute care setting.
Accountable for developing and coordinating the implementation of Discharge Plan A and alternative Plan B, including documentation in the medical record
Multidisciplinary collaboration with physicians, nursing, social work, and multiple disciplines, departments, payers, and agencies to eliminate barriers to efficient delivery of care in the appropriate setting
Facilitates timely transition plan
Active leadership role in the ongoing management of inpatient length of stay and the reduction of readmissions across the organization
Integrates work with ambulatory and clinic transitional case managers
Leadership in care management rounds, interprets, and integrates the patient’s story into the overall multidisciplinary plan of care
Develops and implements corrective action plans for resolution of complex problematic issues and elevates to leads as necessary
Ensures authorizations have been completed in a timely manner
Collaborates with Utilization Management and synthesizes information in order to reduce avoidable days
Collaborates with Physician Advisor for complex issues
Guides physicians in appropriate clinical documentation
Actively participates in clinical performance improvement activities as assigned
Builds a network of positive working relationships that advocate for the patient
Remains current on clinical practice and protocols impacting clinical reimbursement
What You Need to Be Successful:
Bachelor’s in Nursing or active pursuit of BSN required.
Licensure as a Registered Nurse in the state of Maryland required.
Certified Case Manager (CCM) is preferred.
One year of experience in case management and knowledge of payer mechanisms is preferred.
Two years experience in acute care required, four years clinical healthcare experience preferred.
Additional experience in home health, ambulatory care, insurance industry and/or occupational health is preferred.
We are an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.