CASE MANAGER RN - ED

About the role

Maintains professional and technical knowledge by attending education workshops; reviewing professional publications; establishing personal networks; participating in professional societies.

Assures quality of care by adhering to therapeutic standards; measuring health outcomes against patient care goals and standards; making or recommending necessary adjustments; following system/hospital and nursing division's philosophies and standards of care set by state board of nursing, state nurse practice act, and other governing agency regulations.

Protects patients and employees by adhering to infection-control policies and protocols.

Documents patient status recommendations, care coordination, and discharge planning by charting in patient records.

Maintains continuity among the multidisciplinary team by documenting and communicating actions, irregularities, and continuing needs.

Maintains patient confidence and protects operations by keeping information confidential.

Safeguards safe and effective transitions of care through standard work that helps to promote positive health care outcomes for Excela Health patients.

Responsibilities

• Affirms quality of care by adhering to therapeutic standards; measuring health outcomes against patient care goals and standards; making or recommending necessary adjustments; following system/hospital and nursing division's philosophies and standards of care set by state board of nursing, state nurse practice act, and other governing agency regulations.
• Ensures safe and effective transitions of care through standard work that helps to promote positive health care outcomes for Excela Health patients.
• Protects patients and employees by adhering to infection-control policies and protocols.
• Documents patient status recommendations, care coordination, and discharge planning by charting in patient records.
• Maintains continuity among the multidisciplinary team by documenting and communicating actions, irregularities, and continuing needs.
• Maintains patient confidence and protects operations by keeping information confidential.

Requirements

• Graduated of an accredited nursing program.
• Two (2) years recent healthcare/clinical experience, or recent clinical experience in an emergency department, case management, or utilization review position.
• Strong leadership ability, good organizational skills, independent and critical thinking skills, sound judgment, and knowledge of legal aspects and liability of nursing practice.
• Strong ability to communicate complex and/or controversial topics and concepts to a wide and diverse audience.
• Knowledge of payor/insurance benefits.
• Knowledge of basic office equipment such as copier, fax machine, etc.
• Ability to understand and react effectively in a fast-paced environment. Must have flexibility/prioritization skills.

Qualifications

• Bachelor of Science in Nursing (BSN).
• Case management experience.
• Case management certification.
• License, Certification & Clearances: Current licensure to practice as a Registered Nurse in the State of Pennsylvania; Act 33 with renewal; Act 34 with renewal; Act 73 FBI Clearance.

Skills

• Professional Development: Attend meetings as appropriate and meet regularly with supervisor to exchange pertinent information.
• Continuing Education Activities: Participate in continuing education activities, remaining knowledgeable in area(s) or expertise.
• Confidentiality: Maintains patient and program records in accordance with applicable standards and regulations, grant requirement, etc.
• Utilization: Applies InterQual level of care criteria for Severity of Illness/Intensity of Service Indicators for potential admissions and ED hold patients.
• Denial Management: Initiates contact with the attending physician on cases that do not meet InterQual Level of Care SI/IS indicators in order to clarify plan of care.

Benefits

• Flexible scheduling based on operational need (rotating shifts, weekend rotation).
• Travel may be expected locally between Excela Health locations.

Pay

Salary range: $XX.XX - $XXX.XX per hour.

Schedule

Rotating shifts, weekend rotation.