Clinical Care Coordinator, Case Manager, Care Coordination, Part Time, Day

About the role

The Clinical Care Coordinator, Case Manager coordinates patient progression, utilization management, discharge planning, admission status review, and transitions of care across the continuum. The role collaborates with patients, families, physicians, payers, Hospital Operations Resource Center (HORC), Physician Advisors, and interdisciplinary team members to promote appropriate resource utilization, timely patient placement, optimal clinical outcomes, regulatory compliance, and efficient patient throughput. Specialty assignments may include inpatient services, surgical services, or emergency department operations.

Responsibilities

• Coordinate patient progression, utilization management, discharge planning, admission status review, and transitions of care
• Collaborate with patients, families, physicians, payers, HORC, Physician Advisors, and interdisciplinary teams
• Promote appropriate resource utilization, timely patient placement, optimal clinical outcomes, regulatory compliance, and efficient patient throughput
• Assess complex clinical situations, coordinate care across multiple disciplines, facilitate timely transitions
• Make sound decisions regarding patient progression and resource utilization
• Apply medical necessity criteria, admission status determination, CMS regulations, Medicare, Medicaid, and managed care requirements
• Utilize MCG guidelines, care transitions, patient throughput processes, and electronic case management systems

Requirements

• Bachelor's degree (BSN) in nursing required
• Minimum five (5) years of clinical nursing experience required
• Experience in medical or surgical, perioperative, procedural, or emergency nursing preferred
• Experience in case management and/or utilization review strongly preferred

Qualifications

• Registered Nurse license in the State of New Jersey
• ANCC Case Management Certification preferred

Skills

• Knowledge of acute care nursing, care coordination, discharge planning, utilization management, patient progression, medical necessity criteria, admission status determination, CMS regulations, Medicare, Medicaid, managed care requirements, and healthcare reimbursement
• Knowledge of MCG guidelines, care transitions, patient throughput processes, and electronic case management systems
• Strong communication, collaboration, critical thinking, clinical reasoning, problem-solving, and organizational skills
• Effective partnership with physicians, patients, families, payers, and interdisciplinary healthcare teams while managing multiple priorities
• Proficiency in electronic medical records, case management software, and patient tracking systems
• Ability to assess complex clinical situations, coordinate care across multiple disciplines, facilitate timely transitions, and make sound decisions regarding patient progression and resource utilization
• Maintains professionalism and effectiveness in a fast-paced environment while balancing clinical, operational, and regulatory priorities

Benefits

• Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees)
• Group Term Life Insurance and AD&D (Full Time Employees)
• Flexible Spending Accounts and Commuter Benefit Plans
• Supplemental Voluntary Benefits (e.g., Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.)
• 6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended Illness
• Retirement Plan
• Tuition Assistance
• Employee Assistance Program (EAP)
• Valley Health LifeStyles Fitness Center Membership Discount
• Day Care Discounts for Various Daycare Facilities

Pay

Pay Range: $50.18 - $62.73 per hour

Schedule

• Shift: Day
• Location: The Valley Hospital-Paramus