• Job Title:

  Case Manager - RN - Full-Time Days

• Req:

  2023-0112

• Location:

  Hospital

• Department:

  Case Management

• Schedule:

  with rotation to week-ends and holidays

Ensures collaboration among multiple parties; the patient, family and the multi-disciplinary team (internal and external stakeholders), which may include the payer in an effort to facilitate and coordinate services specific to the patients' needs during an episode of care and/or post-hospitalization. All case manager activities will be client-centric, performed in a proactive manner, require on-going assessment of needs, evaluation of resources, knowledge of associated costs and education as indicated. The case manager is responsible for presenting options in an unbiased fashion to all involved parties and in compliance with HIPAA. Empowerment of the patient or healthcare proxy is expected and maintained so an informed decision regarding continued care needs can be made. Advocacy and education are at the heart of all activities with the basic goal focused on providing best clinical outcomes possible for the patient through evidenced based practice.

Lastly, advocacy is an important aspect in the case manager's role as he/she must take into consideration the patient's ability to safely maintain themselves in the community or when the patient's capacity is in question. The case manager needs to ensure the patient or healthcare proxy has the ability to fully understand the options of care being presented so an informed decision can be made. Also, this could include acting as a mediator between physicians/consultants and families when conflict arises or a change in status occurs that may put up road blocks to a successful transition to the next phase of care.

• Education:
• Registered Nurse: must have a current license in Pennsylvania from the Commonwealth of Pennsylvania, Department of State Bureau of Professional and Occupational Affairs. Bachelor degree preferred.
• Master Level Social Worker: Master of Social Work degree from CSWE accredited school. LCSW preferred.
• Social Worker: Bachelor of Social Work or related field from an accredited school.

• Experience:
• Registered Nurse: a minimum of three or more years of acute care clinical nursing. Recent experience in a hospital, insurance company, or independent review company in utilization, quality review, home care or case management.
• Master level Social Worker: a minimum of three or more years in the acute care setting. Previous social work experience or internship in an acute care hospital setting.
• Social Worker: a minimum of three or more years in the acute care setting. Previous social work experience or internship in an acute care hospital setting.

• Other Skills:
  • General Skills All Disciplines: Excellent verbal and written communication skills. Strong organizational and prioritizing skills. Thorough understanding of managed care systems and utilization review criteria. Knowledge of community resources. Demonstrated leadership abilities. Experience in the use of information systems. Must be able to manage and perform well under stress.
  • Certification and Licensure:
    • All disciplines (RN, MSW and BSW) prefer Certification in Case Management (CCM) which reflects advanced education, practice and work experience.
    • Registered Nurses prefer a Bachelor degree in Nursing.
    • Master's level Social Worker prefers LSW or LCSW. Licensure and certification demonstrates a higher level of commitment to their profession and experience through internship and mentoring by another higher level clinician.