Trinity Health RN Case Manager, Full Time- Days in Hartford, Connecticut
The Case Manager serves as the driver of a collaborative, interdisciplinary process which coordinates, monitors, and plans health care services throughout n episode of illness to meet the individual needs of our patients in order to improve the quality of care, reduce costs of care and enhance patient satisfaction. The Case Manager accomplishes this by acting as a resource and guide for Saint Francis physicians, the entire care delivery team, patients and their families throughout the continuum of available health care services by effectively monitoring, evaluating and integrating direct clinical and supportive services in order to achieve and maintain optimal patient health status and expectations. The Case Manager ensures validity of accurate documentation of severity of illness (profiling) for the Saint Francis System by working with the physician in the concurrent review process. Utilizing a rules based approach to all decision making, the Case Manager assesses, plans, negotiates and procures the care/services for patients of all ages across the continuum to facilitate achievement of high quality, cost-effective patient outcomes. These activities are carried out in varying models specific to the dynamic needs within the established Clinical Program lines, but always guided by the Philosophy of the Division of Continuum of Care Management. Position will require flexibility to work at different campuses, includes on-call responsibility, and an overview of 24 hour care. The Standards of practice for Case Management (CMSA) and the Code of Ethics and Standards for Hospital Continuity of Care (AACC) are incorporated in all policies and activities.
Education: Bachelor of Science in Nursing required; Masters preferred.
Experience: Five years of diversified, progressive experience in acute care and/or other settings within the continuum. Discharge planning, utilization management, home care experience beneficial.
Licensure: Current Registered Nurse - State of Connecticut
Certification: Certification in Case Management (CCM)/Certification in Continuity of Care - Advanced (A-CCC) preferred.
Skills: This position requires a person with a positive attitude who is self directed, pleasant, cooperative, assertive yet compassionate displaying a professional demeanor with patients, families, physicians, and fellow employees. This position requires the knowledge of nursing theory and principles and the sustained ability to remain calm, productive and focused under stress conditions. This position requires an in-depth understanding of and skill in using many nationally recognized medical utilization criteria sets, i.e. Milliman and Robertson, InterQual, and others as needed.
This position requires a through understanding of managed care methodologies, HCFA/OBRA and state of Connecticut regulatory compliance issues, and JCAHO accreditation accountabilities of the Continuum of Care. The Case Manager must possess the ability to use or learn to use computer software and hardware applications. The Case Manager must be able to function in a fast-paced, integrated interdisciplinary model of Patient Focused Care to improve patient care and outcomes
Job Number: 00117272
Location: Hartford, CT
Organization Name: Trinity Health Of New England
Facility: NESF - Saint Francis Hospital
Employment Type: Full time
Shift: Day Shift