Case Manager / Shock Trauma
Facility: University of Maryland Medical Center
Employment Type: Not Indicated
Location: Baltimore, MD Shift/Schedule: ROTATING
Department: STC: COORDINATORS
Posted FTE: 1.0
Job Posting Category:
Hours of Work: M-F 8-4pm
Job ID #: 41277
Benefits Eligible:
Minimum Education:
License/Cert Required: Lic Registered Nurse
Minimum Experience:
Specialty Type: Not Applicable
What You Will Do:
At the University of Maryland Medical Center (UMMC), a designated Magnet facility, we are a team. Nurses and doctors, specialists and therapists, work shoulder-to-shoulder to give our patients the care they deserve. We take time to celebrate each other’s contributions and treat each other with respect by valuing each other’s ideas and opinions. Ultimately, we support each other’s growth. Together, we form a world-class team dedicated to furthering the practice of patient care. The University of Maryland Medical Center is currently seeking a Case Manager / Shock Trauma Unit with a desire to join our team. Located at the University Of Maryland Medical Center (UMMC) in downtown Baltimore near the Inner Harbor and Camden Yards; you won't find a more vibrant place to work!
***RN licensure and 2 years experience in acute care is REQUIRED
The Case Manager at the R Adams Cowley Shock Trauma Center (STC) provides utilization management, care coordination and discharge planning for an assigned patient population. This role is patient focused, outcome-oriented, and based on general and specialty professional standards, and functions within a multi-disciplinary practice model. The scope of the role extends beyond STC and University of Maryland System boundaries and includes authority and accountability to intervene on the behalf of identified patients wherever care is required.
Principal Responsibilities and Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
1. Assesses the needs of individual patients within an assigned case load for care coordination, discharge planning, and utilization management services Facilitates early referral to physical therapy, occupational therapy, social work, risk management, patient advocacy, post-acute services, and quality management when needed. Refers clinical issues and lapses in standards of care to appropriate parties.
2. Creates case management care plans for assigned patients. Comprehensively assesses patients’ requirements for services. Extensively assesses patients’ organizational, and payer needs with regard to meeting clinical and financial goals, and patient/provider satisfaction.
3. Facilitates multi-disciplinary collaboration. Collaborates with colleague case managers in providing coordination of care. Works with a multi-disciplinary team to develop a treatment plan, including contingency plans. Contributes to problem solving within the team through communication, collaboration, data collection, obtaining consensus, and evaluating outcomes of treatment options.
4. Implements strategies for case management care plans.
A. Intervenes on behalf of the patient and organization to achieve above stated goals
B. Informs patients and families about services and alternatives and assists them in making informed care decisions.
C. Manages implementation of the treatment plan across the in-patient and out-patient continuum.
D. Facilitates the discharge planning process to assure timely referral, discharge, and access to community services.
E. Negotiates funding options from payers.
5. Ensures Medicare patients receive and understand the discharge Important Message from Medicare within time period directed by Medicare. Supports timely appeals process when patients appeal discharge.
6. Using recognized criteria sets and guidelines, supports physician teams in decisions related to correct level of care for patients, including outpatient, observation and inpatient levels. Supports Condition Code 44 through referral to correct physician advisor.
7. Supports conversion of outpatient and Observation patients to inpatient status as needed for compliance of Medicare 2 Midnight Rule.
8. Supports concurrent appeals process through identification of pended/denied days with interventions including and appropriate referrals and documentation.
9. Continuously monitors and evaluates services and outcomes for assigned patients. Determines extent to which clinical, satisfaction, and financial goals are met.
A. Creates summaries for review with the multi-disciplinary team and for outcomes reporting to executive management, utilization management and department heads.
B. Demonstrates value of program through quantitative evidence of cost-reducing, quality enhancing interventions on the behalf of patients and the organization.
Employee Benefits
As a UMMC employee, and a part of the University of Maryland Medical System (UMMS), you will enjoy a comprehensive benefits program designed with you and your dependents in mind. Subject to any eligibility waiting period, all of the benefits are available to regular full-time employees and most benefits are available to regular part-time employees who are regularly scheduled to work twenty (20) or more hours per week. Many benefits are provided at no cost to employees. For others, the cost is shared between UMMC and employees.
~CB
*LI-AB1
What You Need to Be Successful:
* Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required. Bachelor’s degree and certification as case manager are both preferred.
* Two (2) years experience in acute care required.
* Four (4) years clinical nursing experience preferred.
* One year of experience in case management and knowledge of payer mechanisms and clinical utilization management is preferred. Additional experience in home health, ambulatory care, and/or occupational health is preferred.
* Four (4) years clinical experience which includes demonstrated effectiveness in coordinating care for a broad range of high risk and complex patients is required. Experience in acute care as well as home health, ambulatory care, and/or occupational health is preferred.
* Strong clinical background, with trauma or case management experience desired.
* Knowledge of managed care, discharge planning, utilization and case management. Highly effective verbal and written skills, strong communication skills and experience dealing with physicians.
* Excellent analytical and team building skills; the ability to prioritize and work independently. Must be self-confident and possess the ability to work collaboratively with other disciplines.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
Facility: University of Maryland Medical Center
Employment Type: Not Indicated
Location: Baltimore, MD Shift/Schedule: ROTATING
Department: STC: COORDINATORS
Posted FTE: 1.0
Job Posting Category:
Hours of Work: M-F 8-4pm
Job ID #: 41277
Benefits Eligible:
Minimum Education:
License/Cert Required: Lic Registered Nurse
Minimum Experience:
Specialty Type: Not Applicable
What You Will Do:
At the University of Maryland Medical Center (UMMC), a designated Magnet facility, we are a team. Nurses and doctors, specialists and therapists, work shoulder-to-shoulder to give our patients the care they deserve. We take time to celebrate each other’s contributions and treat each other with respect by valuing each other’s ideas and opinions. Ultimately, we support each other’s growth. Together, we form a world-class team dedicated to furthering the practice of patient care. The University of Maryland Medical Center is currently seeking a Case Manager / Shock Trauma Unit with a desire to join our team. Located at the University Of Maryland Medical Center (UMMC) in downtown Baltimore near the Inner Harbor and Camden Yards; you won't find a more vibrant place to work!
***RN licensure and 2 years experience in acute care is REQUIRED
The Case Manager at the R Adams Cowley Shock Trauma Center (STC) provides utilization management, care coordination and discharge planning for an assigned patient population. This role is patient focused, outcome-oriented, and based on general and specialty professional standards, and functions within a multi-disciplinary practice model. The scope of the role extends beyond STC and University of Maryland System boundaries and includes authority and accountability to intervene on the behalf of identified patients wherever care is required.
Principal Responsibilities and Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
1. Assesses the needs of individual patients within an assigned case load for care coordination, discharge planning, and utilization management services Facilitates early referral to physical therapy, occupational therapy, social work, risk management, patient advocacy, post-acute services, and quality management when needed. Refers clinical issues and lapses in standards of care to appropriate parties.
2. Creates case management care plans for assigned patients. Comprehensively assesses patients’ requirements for services. Extensively assesses patients’ organizational, and payer needs with regard to meeting clinical and financial goals, and patient/provider satisfaction.
3. Facilitates multi-disciplinary collaboration. Collaborates with colleague case managers in providing coordination of care. Works with a multi-disciplinary team to develop a treatment plan, including contingency plans. Contributes to problem solving within the team through communication, collaboration, data collection, obtaining consensus, and evaluating outcomes of treatment options.
4. Implements strategies for case management care plans.
A. Intervenes on behalf of the patient and organization to achieve above stated goals
B. Informs patients and families about services and alternatives and assists them in making informed care decisions.
C. Manages implementation of the treatment plan across the in-patient and out-patient continuum.
D. Facilitates the discharge planning process to assure timely referral, discharge, and access to community services.
E. Negotiates funding options from payers.
5. Ensures Medicare patients receive and understand the discharge Important Message from Medicare within time period directed by Medicare. Supports timely appeals process when patients appeal discharge.
6. Using recognized criteria sets and guidelines, supports physician teams in decisions related to correct level of care for patients, including outpatient, observation and inpatient levels. Supports Condition Code 44 through referral to correct physician advisor.
7. Supports conversion of outpatient and Observation patients to inpatient status as needed for compliance of Medicare 2 Midnight Rule.
8. Supports concurrent appeals process through identification of pended/denied days with interventions including and appropriate referrals and documentation.
9. Continuously monitors and evaluates services and outcomes for assigned patients. Determines extent to which clinical, satisfaction, and financial goals are met.
A. Creates summaries for review with the multi-disciplinary team and for outcomes reporting to executive management, utilization management and department heads.
B. Demonstrates value of program through quantitative evidence of cost-reducing, quality enhancing interventions on the behalf of patients and the organization.
Employee Benefits
As a UMMC employee, and a part of the University of Maryland Medical System (UMMS), you will enjoy a comprehensive benefits program designed with you and your dependents in mind. Subject to any eligibility waiting period, all of the benefits are available to regular full-time employees and most benefits are available to regular part-time employees who are regularly scheduled to work twenty (20) or more hours per week. Many benefits are provided at no cost to employees. For others, the cost is shared between UMMC and employees.
~CB
*LI-AB1
What You Need to Be Successful:
* Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required. Bachelor’s degree and certification as case manager are both preferred.
* Two (2) years experience in acute care required.
* Four (4) years clinical nursing experience preferred.
* One year of experience in case management and knowledge of payer mechanisms and clinical utilization management is preferred. Additional experience in home health, ambulatory care, and/or occupational health is preferred.
* Four (4) years clinical experience which includes demonstrated effectiveness in coordinating care for a broad range of high risk and complex patients is required. Experience in acute care as well as home health, ambulatory care, and/or occupational health is preferred.
* Strong clinical background, with trauma or case management experience desired.
* Knowledge of managed care, discharge planning, utilization and case management. Highly effective verbal and written skills, strong communication skills and experience dealing with physicians.
* Excellent analytical and team building skills; the ability to prioritize and work independently. Must be self-confident and possess the ability to work collaboratively with other disciplines.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.