Clinical Case Manager- 36hrs

Responsibilities

• Patient Assessment, Care Planning & Care Coordination—45%
• Conduct comprehensive assessments to identify patient, family, and caregiver needs.
• Develop, implement, and monitor individualized care plans in collaboration with patients, families, providers, and interdisciplinary team members.
• Career care and services across the continuum, including inpatient, outpatient, community-based, and specialty care settings.
• Facilitate timely referrals to internal and external resources, programs, and community agencies.
• Support care transitions and discharge planning to ensure continuity of care and reduce barriers to treatment.
• Monitor patient progress toward established goals and modify care plans as needed.
• Advocate for patients and families to promote access to appropriate healthcare services and resources.
• Patient, Family & Community Engagement—25%
• Educate patients and families regarding diagnoses, treatment plans, available resources, and self-management strategies.
• Collaborate with physicians, nurses, social workers, therapists, and other healthcare professionals to optimize patient outcomes.
• Identify and address barriers to care, including social determinants of health that may impact treatment adherence and health outcomes.
• Serve as a resource and liaison for patients, families, providers, and community partners regarding care coordination services.
• Promote patient and family engagement in care planning and goal setting.
• Foster partnerships with community organizations and service providers to improve access to care and support.
• Documentation, Quality & Population Health Management—25%
• Maintain accurate, timely, and complete documentation in accordance with organizational, regulatory, and payer requirements.
• Participate in quality improvement initiatives, care management programs, and performance metrics related to patient outcomes and resource utilization.
• Ensure compliance with organizational policies, accreditation standards, and applicable federal and state regulations.
• Utilize data and population health tools to identify high-risk patients and support proactive care management interventions.
• Monitor care coordination outcomes and contribute to organizational performance improvement efforts.
• Administrative & Other Duties—5%
• Monitor care coordination outcomes and contribute to organizational performance improvement efforts.
• Attend departmental meetings, training sessions, and professional development activities.
• Participate in organizational initiatives and special projects as assigned.
• Performs other job-related duties as assigned.

Qualifications

• Education and/or Experience Required:
• Bachelor of Science in Nursing (BSN) Required.
• At least 3 years of experience in a healthcare setting required.
• Education and/or Experience Preferred:
• Pediatrics, Case Management, Discharge Planning preferred.
• Licenses and/or Certifications Required:
• Current State of Connecticut Registered Nurse licensure.
• Licenses and/or Certifications Preferred:
• Case Management Certification.
• Knowledge, Skills and Abilities:
• Demonstrates working knowledge of clinical care management principles, utilization management practices, and the interpretation and application of medical necessity and level-of-care criteria.
• Knowledge of healthcare delivery systems, discharge planning processes, care transitions, and interdisciplinary care coordination.
• Understanding of community resources, treatment options, home health services, durable medical equipment, behavioral health resources, and post-acute care services.
• Knowledge of funding sources, insurance benefits, payer requirements, governmental assistance programs, and other financial resources available to support patient care needs.
• Familiarity with special programs and community-based services that address medical, developmental, behavioral, educational, and social determinants of health.
• Knowledge of applicable federal, state, regulatory, and accreditation standards related to case management and patient care.
• Understanding of patient and family-centered care principles and strategies for engaging patients and caregivers in care planning and decision-making.
• Proficiency in electronic medical records, documentation standards, and healthcare information systems used to support care coordination and case management activities.
• Skilled in computer applications, including Microsoft Word, Excel, Outlook, and other software programs necessary for care coordination, reporting, and data management.
• Applies knowledge of community resources, insurance requirements, and available services to connect patients and families with appropriate supports and resources.
• Abilities:
• Work independently while demonstrating initiative, sound judgment, professionalism, and a collaborative, team-oriented approach.
• Function effectively in a high-energy, fast-paced healthcare environment while maintaining quality, accuracy, and attention to detail.
• Adapt to changing patient needs, priorities, and unit acuity with flexibility and responsiveness.
• Prioritize and manage a complex caseload while meeting deadlines and maintaining continuity of care.
• Collaborate and communicate effectively with interdisciplinary teams, healthcare providers, patients, families, and community partners.
• Communicate clearly, professionally, and compassionately with diverse populations across multiple settings.
• Analyze information, identify barriers to care, and develop practical solutions to support patient and family needs.
• Manage multiple responsibilities simultaneously while maintaining organization and efficiency.
• Exercise critical thinking and problem-solving skills in complex clinical and care coordination situations.
• Maintain confidentiality and handle sensitive information in accordance with organizational policies and regulatory requirements.
• Demonstrate excellent written and verbal communication skills, including documentation, patient education, and professional correspondence.
• Build and maintain effective working relationships with internal and external stakeholders to support coordinated, patient-centered care.

About Us

Connecticut Children’s is the only health system in Connecticut that is 100% dedicated to children. Established on a legacy that spans more than 100 years, Connecticut Children’s offers personalized medical care in more than 30 pediatric specialties across Connecticut and in two other states. Our transformational growth establishes us as a destination for specialized medicine and enables us to reach more children in locations that are closer to home. Our breakthrough research, superior education and training, innovative community partnerships, and commitment to diversity, equity and inclusion provide a welcoming and inspiring environment for our patients, families and team members. At Connecticut Children’s, treating children isn’t just our job – it’s our passion. As a leading children’s health system experiencing steady growth, we’re excited to expand our team with exceptional team members who share our vision of transforming children’s health and well-being as one team.