Case Manager - York Hospital - Part-Time

Part-Time - 0.8 FTE/64 Hours Biweekly

Day Shift - Flexible 8 or 12 hour shifts

Every 4th Weekend

General Summary

Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to facilitate a patient's progression of care and the provision of appropriate, cost effective and quality health care. Works in a team model with social work in assigned patient care areas to address patient discharge needs. Provides leadership in the integration of utilization and case management principles.

Duties and Responsibilities

• Reviews assigned patients for medical necessity, utilization management, and appropriateness of setting for continued hospitalization.


• Initiates problem-solving techniques to prevent over and/or under utilization.


• Facilitates and coordinates the progression of patient care to optimize throughput and the utilization of resources to support continuous quality and cost of care efforts.


• Liaisons between utilization management team, third party payers, and the treatment team regarding the identified treatment plan in accordance with contractual guidelines and System policy.


• Assists the patient care team with the identification and coordination of alternative treatment settings to provide appropriate care, maintain quality of care, and reduce cost.


• Identifies conditions which require case management across the care continuum. Collaborates with members of the patient care team to identify interdisciplinary needs


• Collaborates with care management across the system to effectively transition patient care and support value-based care initiatives.


• Completes case management patient assessment, identifies needs, develops a discharge plan, and coordinates discharge needs (DME, Home Health, IV antibiotics, etc.) in collaboration with patients, families, and care team.


• Assists with the collection and analysis of utilization patterns, length of stay, readmissions, avoidable days, and denied cases.


• Brings known or suspected problems of under-, over-, or inappropriate utilization of resources to the attention of the appropriate manager(s).

Common Expectations:

• Demonstrates a commitment to patient, visitor, and staff by complying with all applicable safety regulations, learning the impact of medical errors and methodology that will lead to reduction of errors; reporting actual and potential errors, as well as hazardous conditions; identifying opportunities to standardize processes and “error proof” systems that will lead to increased safety; and participating in safety education programs and root cause analyses as required.


• Prepares and maintains appropriate documentation as required.


• Maintains established policies and procedures, objectives, quality assessment and safety standards.


• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.


• Prepares and presents utilization data analysis as required.


• Participates in the development and delivery of educational information and process improvements related to job accountabilities and case management principles.


• Attends meetings as required.

Qualifications

Minimum Education:

• Associates Degree Required


• Bachelors Degree Preferred

Work Experience:

• 2 years Recent acute care experience Required


• Field of Experience in Utilization Management, Case Management, or Clinical Nursing Specialty. Preferred

Licenses:

• Licensed Registered Nurse Upon Hire Required or


• Registered Nurse Multi State License Upon Hire Required and


• Basic Life Support Upon Hire Required


• Certified in Case Management Preferred

Knowledge, Skills, and Abilities:

• Excellent interpersonal and communication skills.


• Basic computer skills.


• Desire and ability to work in a supportive and collaborative team environment.

Benefits Offered:

• Comprehensive health benefits


• Retirement savings plan


• Paid time off (PTO)


• Education assistance


• Financial education and support, including DailyPay


• Expanded Paid Parental Leave

For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org)