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About the Role

The Case Manager is responsible for ensuring high-value patient care that is coordinated, efficient, and aligned with institutional clinical and financial objectives. They collaborate with the healthcare team, utilizing evidence-based practice to achieve patient outcomes and manage resources within fiscal time frames. The Case Manager also evaluates practice patterns and supports efforts to improve patient care and operational efficiency.

Responsibilities

• Coordinate and ensure the implementation of the plan of care as part of the interdisciplinary health care team.
• Establish a system for coordinating patient care throughout the continuum, linking inpatient and outpatient services.
• Optimize hospital systems impacting quality and length of stay.
• Identify and monitor compliance with variances from established parameters in the clinical pathway or treatment plan.
• Ensure patients meet clinical needs for admission, treatment, and discharge, initiating appropriate follow-through.
• Assist clinicians in documenting the appropriateness of admissions and continued stays.
• Manage Medicare notices of non-coverage and provide documentation for appeals.
• Ensure the development and implementation of an appropriate discharge plan with healthcare team members.
• Ensure the discharge plan provides a continuum of care with appropriate outpatient physicians and services.
• Contact appropriate outside agencies and initiate/follow through with necessary referrals.
• Link patients and families with institutional or community resources, advocating for scarce resources and developing new ones.
• Collaborate with PSM and unit leadership to involve clinical nurses in discharge planning.
• Act as a patient advocate.
• Demonstrate awareness of ethical/legal issues in patient care and strive to reduce risk.

Requirements

• Minimum of a Baccalaureate degree in a clinically related field.
• Active RN Licensure in Connecticut.
• Minimum of three (3) years of relevant clinical experience.
• Recent appropriate nursing experience.
• Theoretical knowledge of the nursing process, case management, and continuity of care.
• Advanced communication and interpersonal skills with all levels of internal and external customers.
• Ability to obtain and interpret information appropriate to patient needs and age.
• Advanced assessment and teaching skills.
• Leadership skills in planning and managing patient care acquired through greater than 3 years of clinical nursing experience in an acute care hospital.
• Utilization management and case management experience preferred.
• Knowledge of computer software and hardware applications.
• Basic knowledge of statistics.
• Must be able to speak and hear in a manner understood by most people.
• Must be able to communicate effectively by telephone.

Skills

• Case management
• Continuity of care
• Communication
• Interpersonal skills
• Assessment
• Teaching
• Leadership
• Utilization management
• Computer software and hardware applications
• Statistics

Location

• Connecticut

Work Type

• Full-time

Experience Level

• 3+ years clinical experience

Education Level

• Baccalaureate degree
• RN

About the Company

• To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

Equal Opportunity

• EEO/AA/Disability/Veteran