CASE MANAGER
Up to $10,000 Sign on Bonus for qualified Case Managers!
This is an onsite position.
Main Function
The Case Manager coordinates, negotiates, procures services, resources for and manages the care of complex patients to facilitate achievement of quality and cost, patient outcomes. The Case Manager works collaboratively with interdisciplinary staff internal and external to the organization. The Case Manager participates in quality improvement and evaluation processes related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case Manager's average caseload will be: 15-25. The Case Manager will work cooperatively within the care team.
Duties And Responsibilities
Determines medical necessity and appropriateness of admission and stay in accordance with InterQual.
Prepares Medicare/Non Medicare hospital notices of no coverage (HINN) when patient's level of care is no longer covered according to the guidelines.
Identifies the appropriate patients for Case Management services.
Maintains a working knowledge of the requirements of 3rd party payers most frequently involved with their caseload population.
Communicates, collaborates, and coordinate with physicians, other members of the team, the patient’s payers and administrators to assess the needs and provide a plan of care for their caseload population.
In conjunction with the patient/family, other members of the health care team, the payer, and available resources, formulates a plan to address assessed needs and issues, implements the plan, evaluates the effectiveness of the plan in meeting established care goals and revises the plan as needed to reflect the changing needs, issues and goal.
Explores and facilitates strategies to reduce length of stay and resource consumption within case managed populations, implements these strategies and documents the results.
Manages each patient's transitions through the Health Care system and maintains appropriate documentation of the patient care and progress.
Identifies the need, arranges for and conducts health care team meetings when necessary to facilitate the coordination of services and resources in complex situations.
Seeks and provides peer consultation about cases presenting problems and/or experiencing significant deviation from the plan of care.
Consistently attends daily care rounds and participates in them.
The Case Manager tracks and trends LOS, resource utilization , outliers, readmissions, denials, delay days and satisfaction of the case managed population.
Maintains a close working relationship with physicians managing the care of their caseload population.
Coordinates patient discharge and transfers based on the patients need and available resources.
Coordinates services, i.e. home help, DME etc, based on patient need and resources available.
This job description lists typical duties for the classification and is not to be considered inclusive of all duties that may be assigned.
Meetings
Case management staff meeting. Staff development meetings. Programs of care.
Education
Graduate of an approved registered nursing program with a current license as a registered nurse. BSN or Case Management Certification preferred.
Experience
Three to five years clinical nursing in acute care hospital setting preferred. Case management experience preferred but not required.
Cardiopulmonary Resuscitation (cpr) Requirements
Basic Life Support (BLS) required within 90 days of hire date.
About Us
Arnot Health offers patient-centered, comprehensive health services to the Southern Tier of New York. Campuses include Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; Ira Davenport Memorial Hospital in Bath, NY; and over 40 medical offices in the Southern Tier. Arnot Health is currently affiliated with more than 300 physicians from 50+ specialties.
Arnot Health is a member of Centralus Health, a community-based integrated delivery system. Our mission is to deliver high-quality care, empower our teams to succeed, and improve the wellbeing of the communities we serve.
Our commitment to quality personalized care begins with our exceptional team—over 6500 employees strong. At Arnot Health, you will work in a collaborative environment that values excellence, integrity, compassion, and stewardship. Together, we create an environment where empathy, honesty and a dedication to quality thrive, empowering us to make a positive impact on the lives we touch.
We offer competitive wages, comprehensive benefits, and professional development opportunities to help our employees grow and thrive. Whether you are just starting your career or taking the next step in healthcare, we invite you to join us in shaping the future of care in our communities.