Lead Nurse Case Manager

Job Description

Lead Nurse Case Manager

Full-time / Day-Shift (Mon-Fri 8 : 30a-5p)

UM Charles Regional - La Plata, MD

General Summary

Under limited supervision, assists the manager of Case Management Services in overseeing the accuracy, completeness and consistency of the case management team, which includes but is not limited to : pre-admission, admission, concurrent and retrospective reviews of all patients;

coordination of all systems and services required for an organized, interdisciplinary team approach to healthcare; assures quality, cost effective care and efficient utilization of resources and health services across the healthcare continuance.

Patients served include neonate through adult-geriatric. Provides guidance in regards to policies and procedures related to patient flow, discharge process and care coordination.

Provides input regarding human resource functions. Provides input into performance improvement strategies. Assists with staff orientation, mentoring and other operational issues.

Assists in the daily activities of Case Management Services staff including making adjustments to staffing assignments as indicated.

Qualifications

Education and Experience

• 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 required; BSN preferred.
• 5 years of clinical experience in a healthcare setting.
• Must have previous Case Management and Utilization experience; CCM (Certified Case Manager) or ACM (Accredited Case Manager) preferred.

Knowledge, Skills and Abilities

• Demonstrates knowledge and skills to provide care appropriate to the age of patients served. Demonstrates knowledge of the principles of growth and development over the life span and possesses the ability to assess data reflective of the patient’s requirements relative of his or her age-specific needs.
• Knowledge of managed care, discharge planning, utilization and care coordination is required.
• Knowledge of medical records and the ability to interpret contents and relay information to payer and others as needed is required.
• Ability to identify problems, develop course of action and follow through to resolution is required.
• Ability to communicate effectively and positively, both written and verbally, with staff, physicians, other hospital personnel, patients and the general public required.
• Excellent analytical and team building skills, as well as the ability to prioritize and work independently is required.
• Must possess the ability to work collaboratively with other disciplines.
• Ability to work with Hospital / Case Management related software programs required.
• Provides orientation and mentorship to new and existing staff members.
• Has input into the hiring / interview process for new case manager, social work and technician applicants.
• Collaborates with Manager on performance improvement metrics.
• Performs medical record reviews and audits to ensure compliance metrics achieved.
• Participates in assigned committees.
• Ability to ensure the confidentiality and rights of patients and the confidentiality of hospital and departmental documents required.
• Ensures patient safety in the performance of job functions and through participation in hospital, department or unit patient safety initiatives

Additional Information

All your information will be kept confidential according to EEO guidelines.