The Clinical Care Coordinator, Case Manager is responsible for coordinating patient progression, utilization management, discharge planning, admission status review, and transitions of care across the continuum. The role collaborates with patients, families, physicians, payers, Hospital Operations Resource Center (HORC), Physician Advisors, and interdisciplinary team members to promote appropriate resource utilization, timely patient placement, optimal clinical outcomes, regulatory compliance, and efficient patient throughput. Specialty assignments may include inpatient services, surgical services, or emergency department operations.
Responsibilities
Coordinating patient progression; Utilization management; Discharge planning; Admission status review; Transitions of care across the continuum; Collaborating with patients, families, physicians, payers, Hospital Operations Resource Center (HORC), Physician Advisors, and interdisciplinary team members; Promoting appropriate resource utilization, timely patient placement, optimal clinical outcomes, regulatory compliance, and efficient patient throughput; Specialty assignments may include inpatient services, surgical services, or emergency department operations
Requirements
Bachelor's degree (BSN) in nursing; Registered Nurse; Licensed in State of New Jersey; Minimum five (5) years of clinical nursing experience; Knowledge of acute care nursing, care coordination, discharge planning, utilization management, patient progression, medical necessity criteria, admission status determination, CMS regulations, Medicare, Medicaid, managed care requirements, and healthcare reimbursement; Knowledge of MCG guidelines, care transitions, patient throughput processes, and electronic case management systems; Strong communication, collaboration, critical thinking, clinical reasoning, problem-solving, and organizational skills; Proficient in electronic medical records, case management software, and patient tracking systems; Ability to assess complex clinical situations, coordinate care across multiple disciplines, and make sound decisions regarding patient progression and resource utilization
Nice to have
ANCC Case Management Certification; Experience in medical or surgical, perioperative, procedural, or emergency nursing; Experience in case management and/or utilization review
Benefits
Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees); Group Term Life Insurance and AD&D (Full Time Employees); Flexible Spending Accounts and Commuter Benefit Plans; Supplemental Voluntary Benefits (e.g. Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.); 6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended Illness; Retirement Plan; Tuition Assistance; Employee Assistance Program (EAP); Valley Health LifeStyles Fitness Center Membership Discount; Day Care Discounts for Various Daycare Facilities
Stany Zjednoczone · Paramus
