CASE MANAGER SUPPORT

System Support; City of Troy (NY); On-site; USD 70,000 - 95,000; Full time

Job summary

Upper Valley Medical Center's Integrated Care Management team seeks a Care Manager to coordinate cost-effective, high-quality care. You will collaborate with patients, families, and providers to assess needs, plan transitions, and support education and social resources.

The role requires a BSN, Ohio RN licensure, and 3–5 years of acute care experience with utilization/case management knowledge. Strong communication and analytical skills are essential.

Qualifications

• Nursing theory knowledge from an accredited program.
• BSN required.
• Current Ohio State license as a Registered Nurse.
• 3–5 years of acute care experience with utilization/case management knowledge.
• Interpersonal skills to educate and support patients and families.
• Analytical and problem-solving abilities; basic computer skills.

Responsibilities

• Assess, coordinate, and monitor care to meet individual needs.
• Review patient records for discharge planning and utilization issues.
• Refer to Social Services, Home Care Liaison, and Patient Education as needed.
• Participate in daily huddles and care coordination activities.
• Support patient and physician satisfaction goals.

Skills

BSN

RN license

Utilization management

Discharge planning

Communication

Problem solving

Education

BSN

Job description

General Summary/Responsibilities:STATUS: PRN / SupportDepartment: INTEGRATED CARE MGT PROGRAMFacility: Upper Valley Medical CenterUnder the general supervision of the Manager of Integrated Care Management, the Care Manager works collaboratively with the Care Management Team to interact with patients/families and healthcare providers to insure that cost effective, quality care is provided throughout the continuum of healthcare. He/She assesses, implements, coordinates, monitors, evaluates and communicates options/services needed to meet the individual’s healthcare needs, thus promoting quality & cost effective outcomes. The Care Manager provides a timely review of the patient’s medical record for care management activities, including but not limited to: discharge/transition planning, clinical documentation, utilization management issues (recidivism/length of stay, care delays and avoidable days), admission/continued stay reviews, addressing status issues, providing severity/intensity of illness criteria for CMS and third party payers, and make referrals to Social Services, Home Care Liaison, and Patient Education). He/she participates in risk management and quality measures: recidivism, core measures, missing H&Ps, post-operative note, etc. The Care Manager is in direct contact with patient/family/providers, participates in daily “huddles” on unit for purpose of care coordination and identification of possible barriers to discharge, and actively supports patient and physician satisfaction goals. The Care Manager also mentors and acts as a resource to other health care providers in care management techniques and quality issues. Patients may range in age from newborn to an elderly patient population based on specific assignments.Professional knowledge of nursing theory and practice at a level normally acquired through completion of a nursing degree at an accredited School of Nursing. Additional nursing continuing education preferred. BSN required.Current Ohio State license as a Registered Nurse required.Three to five years of recent acute care experience in combination with/or with knowledge of utilization and case management principles.Interpersonal skills necessary in order to instruct and comfort patients and their families, and maintain effective contacts with a variety of hospital personnel. Recognizes and reinforces positive efforts of all co-workers.Analytical skills necessary for problem solving and conflict resolution.Ability to learn basic computer skills. Word and Access experience preferred.