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Case Manager
Location: Elmira, NY
Up to $10,000 Sign on Bonus for qualified Case Managers!
Brief Description
This is an onsite position.
Main Function
The Case Manager coordinates, negotiates, procures services 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, participates in quality improvement and evaluation processes related to the management of patient care, reviews all patients for utilization management and appropriate discharge planning, and works cooperatively within the care team. The average caseload is 15-25 patients.
Duties and Responsibilities
Determine medical necessity and appropriateness of admission and stay in accordance with InterQual.
Prepare Medicare/Non Medicare hospital notices of no coverage (HINN) when patient's level of care is no longer covered according to the guidelines.
Identify appropriate patients for Case Management services.
Maintain a working knowledge of the requirements of third‑party payers most frequently involved with the caseload population.
Communicate, collaborate, and coordinate with physicians, team members, patient’s payers and administrators to assess needs and provide a plan of care.
Formulate a plan with patient/family, team, payer and resources; implement, evaluate, and revise the plan as needed.
Explore and facilitate strategies to reduce length of stay and resource consumption within case‑managed populations; implement strategies and document results.
Manage each patient’s transitions through the health‑care system and maintain documentation of care and progress.
Arrange and conduct health‑care team meetings when necessary to coordinate services and resources.
Provide peer consultation on cases with significant deviation from the plan of care.
Attend daily care rounds and participate in them.
Track and trend LOS, resource utilization, outliers, readmissions, denials, delay days and satisfaction of the case‑managed population.
Maintain a close working relationship with physicians managing the caseload population.
Coordinate patient discharge and transfers based on needs and available resources.
Coordinate services such as home help or DME based on patient needs 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 meetings, staff development meetings, and 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 an 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.
Physical Demands
Light physical effort. Routine office job. Category I. Tasks that involve exposure to blood, body fluids, or tissues.
Summary
A.D.A. Essential Functions.
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 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. We offer competitive wages, comprehensive benefits, and professional development opportunities.
Seniority Level
Mid‑Senior level
Employment Type
Full‑time
Job Function
Other
Industries
Hospitals and Health Care
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