Nurse Case Manager: E8: Rehab

Albany Medical Center - Hudson, NY

Full-time

Hudson, NY

Hospitals

About the position

The Case Manager is responsible for facilitating the interdisciplinary team to plan, coordinate, implement, and evaluate patient care across the continuum of care. This role involves proactive collaboration with Quality Improvement Teams and utilization management to ensure optimal clinical and financial outcomes. The Case Manager serves as a resource for the healthcare team, patients, and families, functioning as a clinician, consultant, advocate, and educator.

Responsibilities

• Assist the admission MD and interdisciplinary teams in coordinating care across the continuum in the hospital pre and post-op.
• Monitor patients' clinical processes to ensure timely interventions that achieve optimal outcomes within appropriate length of stay and financial constraints.
• Collaborate with the primary nurse in assessing discharge planning needs and coordinating resources.
• Begin the discharge planning process upon admission.
• Manage care across the continuum, including pre-admission, discharge, and post-discharge planning.
• Utilize evidence-based guidelines to provide leadership in formulating individualized multidisciplinary plans of care.
• Facilitate health care team care conferences for patients with complex problems.
• Educate patients and families to promote continuity of care and optimal outcomes.
• Review admission data to clarify diagnoses and establish appropriate length of stay.
• Contact payer sources to confirm benefits and provide concurrent reviews.
• Identify high-risk patients for collaboration with financial services to problem-solve available resources.
• Ensure appropriate medical/legal documentation is maintained in patient records.
• Collaborate with the healthcare team to implement strategies to reduce length of stay and resource consumption.
• Assess educational needs and provide learning opportunities for healthcare professionals.
• Compile and report aggregate variances and data for specific patient care services.

Requirements

• Bachelor's Degree required; Master's Degree preferred.
• 1-3 years of clinical experience in an assigned service required.
• Recent experience in case management, utilization management, or discharge planning in a high-volume acute care hospital preferred.
• Effective communication, facilitation, and organizational skills.
• Assertive and creative in problem solving and critical thinking.
• Self-directed with adaptability in a changing environment.
• Basic knowledge of computer systems applicable to utilization review process.
• RN - Registered Nurse State Licensure and/or Compact State Licensure upon hire required.
• Certified Case Manager and PRI upon hire preferred.