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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 role involves evaluating practice patterns, improving patient care, and enhancing operational efficiency by identifying and resolving trends and barriers.

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 appropriate discharge plans with healthcare team members, identifying service, treatment, and funding options.
• Ensure discharge plans provide 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 to facilities.
• Act as a patient advocate alongside other healthcare team members.
• 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.
• 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
• Utilization management (preferred)
• Advanced communication skills
• Interpersonal skills
• Advanced assessment skills
• Teaching skills
• Leadership skills
• Computer software and hardware applications
• Statistics

Location

• Connecticut

Work Type

• Full-time

Experience Level

• 3+ years clinical experience
• Greater than 3 years clinical nursing experience in an acute care hospital

Education Level

• Baccalaureate degree in a clinically related field
• RN

About the Company

• YNHHS Vision, Mission, and Values (integrity, patient-centered, respect, accountability, and compassion) guide all employees.
• YNHHS Requisition ID 163512

Equal Opportunity

• EEO/AA/Disability/Veteran