Case Manager RN or Masters Social Worker- Outcomes Manager
Responsible for partnering with the physician and multidisciplinary team in coordinating patient care with the underlying objective of enhancing quality and cost effective care.
Acts as a resource and patient advocate to facilitate a safe transition across the continuum.
• Care Coordination – completes appropriate assessments and plans effectively to meet patient needs, monitors the length of stay and promotes efficient utilization of resources. Acts as a clinical expert and maintains ongoing knowledge of clinical practice guidelines. Engages the physician and builds seamless continuity of care and is the physician’s single consistent resource. Problem resolution, patient/family communication. Helps identify factors impeding patient progression, resolves, escalates and documents as appropriate. Refers appropriate cases for Social Work intervention.
• Documentation – Appropriate and complete documentation of individual plan of care in EMR and case management documentation system.
• Metrics - Accountable to job specific goals, objectives and dashboards which contribute to the success of the organization.
• Participates in organizational improvement activities including patient satisfaction, Six Sigma committee, department and/or divisional teams and community activities.
• Compliance – understands and applies applicable federal and state requirement. Identify and reports compliance issues as appropriate.
Position Qualifications Required / Experience Required:
Required: Must be RN or Masters prepared Licensed Social Worker.
Preferred: 3 years clinical nursing (RN) experience and 1 year UR/CM/QM experience or 3 years experience as Clinical Social Worker. Basic understanding of Medicare, Medicaid and managed care. Discharge planning or home health background.
Excellent verbal and written communication skills, problem solving, critical thinking and conflict resolution.
Graduate of an accredited School of Nursing or Graduate of an approved School of Social Work with a Bachelor’s or Master’s Degree.
Licensure and/or certification from the State of New Jersey as a MSW or Registered Nurse.
Case Management Certification (requirement within one year of hire beginning April 1, 2015).
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