Case Manager, BSN- Care Coordination, Per Diem, Vineland/Elmer

Inspira-Health-Network; Vineland (NJ); Sur place; USD 90 000 - 110 000; Plein temps

Résumé du poste

Inspira Health Network seeks an RN to coordinate patient care from pre-admission to discharge, ensuring appropriate, cost-effective services and timely transitions.

The role collaborates with physicians, nurses, social workers, and the care team, applying clinical judgment and utilization criteria to optimize outcomes and prevent readmission.

Qualifications

• BSN required for hires after 01/09/2021; associate degree required for Mannington hires before/after deadline.
• Minimum 3 years of hospital experience required; 1–3 years in case management preferred.
• RN licensure in New Jersey required; CCM/ACM/CMC/RNBC/CPUR/NCBC preferred.

Responsabilités

• Facilitate hospitalization from pre-admission through discharge.
• Collaborate with physicians, nurses, social workers and care team to ensure appropriate, cost-effective care.
• Utilize Milliman criteria to review admission/continued stay and develop timely discharge plans.

Connaissances

Communication skills

Microsoft Office

Independent work

Milliman criteria knowledge

Formation

BSN

Associate degree

Outils

Microsoft Office

Description du poste

MAJOR FUNCTION:Facilitates a patient’s hospitalization from pre-admission through discharge. Collaborates with physicians, nurses, social workers and other members of the healthcare continuum to ensure appropriate, cost-effective care. Applies clinical expertise and medical necessity criteria to perform the functions of utilization management, care coordination, resource utilization, and discharge planning. Must utilize established criteria to review appropriateness of admission and continued stay. Perform initial and ongoing assessment to ensure a timely transitional care plan is developed that will support each patient’s needs and prevent hospital readmission. Identify and prevent potential barriers in transition of care. Ensure discharge plan is consistent with patient’s clinical course, continuing care needs, and covered services. Identify patients and/or families who require social work referral. Actively participate in multidisciplinary rounds. Collaborate with next level of care providers as appropriate.QUALIFICATIONS:Education & Experience:BSN required if hired after September 1, 2021. For Mannington only, all hired on or after June 1, 2023 have BSN required, or must enrolling a BSN program by 6 months of employment and obtain their BSN by their 3rd work anniversary in a BSN required position.Hired prior to BSN preferred, associate degree required.Minimum 3 years of experience in hospital setting required.1-3 years of case management experience preferred.Clinical background in assigned unit/service line preferred.Previous utilization management experience preferred.Previous experience with regulatory and compliance requirements preferred.Certification/Licensure:Licensed Registered Nurse in New Jersey required.CCM, ACM, CMC, RNBC, CPUR or NCBC preferred.Knowledge & Skills:Demonstrates excellent communication skills (oral and written) and interpersonal skills necessary to communicate with families, patients, interdisciplinary healthcare team members, vendors, and third-party payors for optimum care.Excellent clinical and administrative skills and judgement.Proficiency in Microsoft Office.Ability to work independently, setting priorities to coordinate care plans efficiently.Working knowledge of Milliman criteria preferred.Physical Requirements: N: Never O: Occasionally (80%)LiftingFStandingFSittingCLifting 20-50lbsOClimbingOKneelingOLifting>50lbsNCrouchingOReachingFCarryingOHearingCWalkingFPushingOTalkingCVisionCEnvironmental Conditions:NoiseFVaried TemperaturesOCleaning AgentsONoxious odorsNPatient ExposureFOperative EquipmentNBENEFITS INFORMATION:Click Here to Review Our Great Benefits Offerings?>At Inspira Health, you’ll join with the area’s most dedicated and distinguished team to bring quality and compassionate care to our communities. We focus on clinical excellence, providing evidence-based care to help each patient achieve the best possible outcome. The scope and depth of our network can open many doors for your learning and career growth.Our charitable nonprofit health care organization serves communities across southern New Jersey. The network, which traces its roots to 1899, comprises three hospitals, a comprehensive cancer center, sleep medicine, cardiac testing, digestive health and wound care, urgent care, imaging and rehabilitation, and primary and specialty physician practices in Gloucester, Cumberland, Salem and Camden counties.Inspira is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, creed, color, national origin, ancestry, age, marital status, affectional or sexual orientation, familial status, disability, liability for service in the Armed Forces of the United States, nationality, sex, gender identity or expression.