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Case Manager II - (Pediatric Associates)

Company: Christiana Care
Location: Newark
Posted on: September 12, 2019

Job Description:

PRIMARY FUNCTION:

Serves as mentor and preceptor to care management staff while coordinating the utilization of healthcare resources, including transition planning, while facilitating the achievement of clinical, quality, financial and member satisfaction goals across identified risk populations

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Perform ongoing telephonic and/or embedded case management activities of assessment, problem identification, planning, implementation, coordination, monitoring, and evaluation of members. Stratifies and/or validates member level of risk during each transition process and interaction with the member.

Collaborates with members, caregivers and members of the multi-disciplinary care team to develop a member centered plan of care to meet identified member care goals and outcomes

Develop, implement, evaluate and revise case management care plans according to case management eligibility criteria, contractual guidelines and members physical and psychological needs throughout the continuum of care

Identifies system issues that serve as barriers to care. Participates in development and implementation of strategies to remove barriers and promote resolution through coordination of a problem solving process

Promote member wellness and autonomy through advocacy, communication, education, and identification and referral to community resources or other case management programs such as disease management programs

Collaborate with healthcare professionals throughout the care continuum to facilitate the transition of the member/beneficiary to the appropriate level of care.

Demonstrates knowledge of utilization management and care coordination processes and current standards of care as a foundation for transition planning, complex case management and disease management activities

Confers with Medical Directors regarding complex cases requiring physician input regarding the treatment plan or physician to treating physician collaboration

Serves as preceptor to all new orientees

Receives Super-user training on a variety of programs, IT software, educational

presentations and work with staff in a Super-user capacity to ensure staff compliance

Actively participates in a defined departmental committee.

Mentor staff in various aspect of training related to the principles of practice and care coordination in adherence set forth by the Commission for Case Management

Performs assigned work safely, adhering to established departmental safety rules and practices. Reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, members and visitors

Performs all other related duties as assigned by Manager/Director

EDUCATION AND EXPERIENCE REQUIREMENTS:

Registered Nurse with BSN required; experience in Utilization Management or Case Management preferred

Active DE RN Licensure, in good standing.

Case Management Certification required

KNOWLEDGE, SKILL, AND ABILITY REQUIREMENTS:

Strong interpersonal skills relative to member, caregiver, professional and team interactions

Strong organization skills

Demonstrated ability to manage a large population of beneficiaries/members

Demonstrated critical thinking skills and the ability to prioritize workload

Ability to exercise clinical judgment and autonomous decision making

Ability to apply knowledge of case management and utilization management principles and practices.

PHYSICAL DEMANDS:

Ability to ambulate within an office setting (walking, stairs, etc.)

Frequent sitting, standing and lifting loads of 5-10 pounds.Christiana Hospital, Newark, Delaware. This 1,007-bed, 1.3-million-square-foot modern facility provides a level of care only available in large-scale teaching hospitals. Christiana Hospital includes Delaware's only Level-I Trauma center (as verified by the American College of Surgeons), which is prepared to handle the most extreme medical emergencies. In fact, it is the only Level-I Trauma center on the East Coast corridor between Baltimore and Philadelphia. Christiana Hospital has also been nationally recognized in U.S. News and World Report's Best Regional Hospitals rankings as #1 in Delaware and #3 in the Philadelphia metro area, plus High Performing in 9 Adult Procedures/Conditions. Academic medical center, Baltimore area, Best regional hospital, Community-based medicine, Community health, Clinician, Delaware hospital, Delaware's largest health system, Electronic medical records, Epic EMRs, Everest Award-winner, In-patient, Level I Trauma Center, Magnet -- designation, Nationally recognized, Outpatient, Philadelphia area, Provider, Surgery center, Teaching hospital, Wellness, Wilmington, Newark, U.S. New & World Report ranking, Expert, Serve, Care, Healthcare, Respectful, Dover, Bear, Middletown, Rehoboth Beach, Bethany Beach, Delmarva Peninsula, New Castle, Elkton, Maryland, Glasgow, Hockessin, Brookside, Smyrna, Pike Creek Valley, Milford, Claymont, Pike Creek, Wilmington Manor, North Star, Seaford, Southeastern Pennsylvania, Southern New Jersey, Vineland, Millville, West Chester, Kennett Square, Swedesboro, Carneys Point, Woodstown, Salem, Elmer, Deptford Township, Washington Township, Pitman, Glassboro, Franklin

Keywords: Christiana Care, Newark , Case Manager II - (Pediatric Associates), Executive , Newark, Delaware

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