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As a collaborative member of the interdisciplinary team, and a skilled Registered Nurse, the Case Manager is involved in the processes of assessing, planning, organizing, implementing, monitoring and evaluating the services and resources needed to respond to an individual's healthcare/rehabilitation needs by coordinating medical, financial and counseling/social services to patients and families. The Case Manager facilitates and advocates for ethical cost effective, evidence-based services to assure quality of care and attainment of appropriate goals, using appropriate resources, to achieve health and illness management. The Case Manager coordinates treatment, discharge planning, and communication between team members. The Case Manager assists with Utilization Review work by involving the team in determining continued stay criteria are met via the team conference process and provides direct feedback to payers as well as individual patients and families. The Case Manager facilitates patient/family education with a primary focus on adjustment to disability, illness and wellness management, and successful discharge to the community. Responsibilities:
“Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.”
Come join our Amazing team here at Hackensack Meridian Health! We offer Scheduling Flexibility, Tuition Reimbursement, Employee Discounts and much more!!!
As a collaborative member of the interdisciplinary team, and a skilled Registered Nurse, the Case Manager is involved in the processes of assessing, planning, organizing, implementing, monitoring and evaluating the services and resources needed to respond to an individual's healthcare/rehabilitation needs by coordinating medical, financial and counseling/social services to patients and families. The Case Manager facilitates and advocates for ethical cost effective, evidence-based services to assure quality of care and attainment of appropriate goals, using appropriate resources, to achieve health and illness management. The Case Manager coordinates treatment, discharge planning, and communication between team members. The Case Manager assists with Utilization Review work by involving the team in determining continued stay criteria are met via the team conference process and provides direct feedback to payers as well as individual patients and families. The Case Manager facilitates patient/family education with a primary focus on adjustment to disability, illness and wellness management, and successful discharge to the community.
- Data collection and assessment pertaining to patients' medical, social, financial, familial and psychologic situation as well as any social determinants of health that may impact recovery or present a barrier to adjustment to disability, discharge to the community, or health management.
- Develops a comprehensive plan by establishing realistic, patient centered goals to achieve optimal outcomes in collaboration with the patients, families, treating team, and payers. Case Manager establishes target dates for goal achievement and provides education and information to patients/families to access available resources/services in support of those goals.
- Implementation and facilitation of planning, resources and services assuring ongoing assessment and contingency planning in support of the patients' successful discharge to the community whenever possible.
- Utilizes all clinical and case management skills to advocate for positive patient outcomes that are cost effective, patient specific, ethical and are within the accepted guidelines for standards of care.
- Effective spoken and written communication to and with patients, families, payers and team members in the execution of the patients' plans of care
- Actively participates in the Utilization Review process as a measure of resource management stewardship in the care delivery system.
- Other duties and/or projects as assigned.
- Adheres to HMH Organizational competencies and standards of behavior.
- Minimum of three years clinical experience.
- Graduate of BSN/Bachelor's Degree program or equivalent work-related experience.
- Demonstrated accountability and skills in analysis, problem solving, decision making, time management and oral and written communication.
- Familiarity with resources available regarding the regulations and parameters of third-party reimbursement.
Education, Knowledge, Skills and Abilities Preferred:
- Case Management/UR experience.
- Clinical experience in the management of chronically or catastrophically ill or injured patients.
Licenses and Certifications Required:
- Current and valid New Jersey Nursing license.
Licenses and Certifications Preferred:
- CCM, National Certification, is preferred or willingness to prepare for and achieve the CCM credential.
- CRRN or National Certification, in area of specialty.
