Current UPHS employees must apply HERE
Case Manager RN Float- Full Time-Days- Princeton Health
Job ID: 160393
Work Type: FT
Location: Plainsboro, NJ, United States
Date Posted: Dec 14, 2022
Work Schedule: Full Time M-F 8-5
Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.
Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
- The Case Manager Float supports the interdisciplinary team in facilitating patient care with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payors. The role integrates care facilitation and discharge planning functions. In addition, the Case Manager Float helps drive change by identifying areas where performance improvement is needed. (e.g., day to day workflow, education, process improvements, patient satisfaction)
- Works collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient management.
- Addresses/resolves system problems, impending diagnostic or treatment progress. Proactively identifies and resolves delays and obstacles to discharge.
- Ensures that all elements critical to the plan of care have been communicated to the patient/family and members of the healthcare team and documented as necessary to assure continuity of care.
- Meets directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with physician and medical team.
- Documents relevant discharge planning information in the electronic medical record.
- Collaborates and communicates with multidisciplinary team in all phases of discharge planning process, including initial patient assessment, planning, implementation, interdisciplinary collaboration, teaching and ongoing evaluation.
- Refers appropriate cases for social work intervention based on department criteria.
- Initiates and facilitates referrals for home health care, hospice, medical equipment and supplies.
- Identifies trends in inappropriate utilization of resources, including, but not limited to, delays in diagnostic testing, medical surgical procedures and physician management.
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competence, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
- Communicates relevant clinical information including admission review, concurrent review and discharge planning needs, to third party payors to secure optimal reimbursement.
- Applies InterQual criteria to monitor appropriateness of admissions and continued stays and documents findings in the electronic health record.
- Follows 100% of assigned inpatient admissions.
- Determines medical appropriateness of the patient’s admission (severity of service)
- Monitors the plan of care and proactively identifies barriers to the plan (intensity of service)
- Intervenes to avoid delays in plan of care.
- Coordinates the flow of clinical information with third party payors to ensure appropriate reimbursement, proactively identifies potential denials in order to avoid non-appealable denials.
- Registered Nurse - NJ (Required)
- Certified Case Manager
Education or Equivalent Experience:
- Bachelor of Science Nursing (Required)
- And minimum of 3 years Medical-Surgical/Critical Care experience
And 1+ years Case Management/Utilization Review preferred
We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.
Live Your Life's Work
We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.
Current UPHS employees must apply HERE