Coordinates the utilization of healthcare resources, including transition planning, facilitate the achievement of clinical, quality, financial and patient satisfaction goals.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Perform ongoing telephonic case management activities of assessment, problem identification, planning, implementation, coordination, monitoring, and evaluation of case managed patients or beneficiaries Collaborates with members, caregivers and members of the multi-disciplinary care team to develop a patient centered plan of care to meet identified patient care goals and outcomes Develop, implement, evaluate and revise case management care plans according to case management eligibility criteria, contractual guidelines and patient or beneficiaries physical and psychological needs throughout the continuum of care Identifies system issues that serve as barriers to care. Participates in development and implementation of strategies to remove barriers and promote resolution through coordination of a problem solving process Promote patient wellness and autonomy through advocacy, communication, education, and identification and referral to community resources or other case management programs such as disease management programs Identify appropriate providers and facilities through the continuum of services, and ensure that available resources are being used in a timely and cost effective manner Collaborate with embedded and inpatient case managers in the discharge and transitional care process, obtaining and/or coordinating appropriate resources for patients throughout the continuum of care Stratifies and/or validates patient level of risk during each transition process and interaction with the patient or beneficiary Collaborates with health care providers in settings not limited to the PCP office, hospital, skilled nursing facility or home care agencies to assist patients or beneficiaries in coordinating safe transitions and enhanced communication of the treatment plan to all members of the multidisciplinary care team Makes referrals to the pharmacist, social worker, respiratory therapist or community outreach team as needed to provide holistic approach to care ensuring safe transitions of care and education Manages assigned case load in an efficient and effective manner utilizing time management skills to facilitate the total work process directly monitoring assigned patients or beneficiaries Demonstrates knowledge of utilization management and care coordination processes and current standards of care as a foundation for transition planning, complex case management and disease management activities Confers with Medical Directors regarding complex cases requiring physician input regarding the treatment plan or physician to treating physician collaboration Adheres to organizational and departmental policies and procedures and credentialed compliance Performs assigned work safely, adhering to established departmental safety rules and practices. Reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors. Performs all other related duties as assigned by Manager/Director The ideal candidate for this position would have experience working in Oncology
EDUCATION AND EXPERIENCE REQUIREMENTS:
Registered Nurse with BSN required or relevant experience in Utilization Management or Case Management Active DE RN Licensure, in good standing. Case Management Certification preferred through the Commission for Case Management (CCM) or within 18 months of hire after completion of 6 weeks of orientation
KNOWLEDGE, SKILL, AND ABILITY REQUIREMENTS:
Strong interpersonal skills relative to both professional and team interactions
Internal Number: 48131BR
About Christiana Care Health System
Christiana Care Health System is headquartered in Wilmington, Delaware and is one of the country's largest health care providers, ranking 21st in the nation for hospital admissions. Christiana Care is proudly a Nurse Magnet recognized institution. Christiana Care Health System is also one of the largest health care providers in the mid-Atlantic region, serving all of Delaware and portions of seven counties bordering the state in Pennsylvania, Maryland and New Jersey. A not-for-profit, non-sectarian health system, Christiana Care includes two hospitals with more than 1,100 patient beds, and is a major teaching hospital with two campuses. Christiana Care is continually recognized for excellence on a regional and national level. Our role in the community is expressed in the Christiana Care Way: "We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value."Christiana Care is a great place to work because we value diversity and recognize it to be a core part of our success. Because of the diversity of our employees, affiliated health professionals and volunteers, we are... positioned to meet the unique needs of our patients and community. We acknowledge and celebrate the uniqueness and talent of each employee. Because of our talented workforce we are able to provide a quality healthcare experience to our patients and community. We strive to create an inclusive environment in which individual diversity can be leveraged and thrive. Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.