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Registered Nurse Case Manager MHB

Location: Buffalo, NY, United States
Date Posted: May 28, 2019

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Job Description

Status: Full Time Facility: Mercy Hospital of Buffalo

Work Schedule: Days with Weekend and Holiday Rotation Shift: 1:

Exempt from Overtime: Exempt: No FTE: 1.000000: Bargaining Unit: CWA Local 1133

Summary:

As a member of the multidisciplinary healthcare team, The Case Manager affects a process of assessment, planning, facilitation and advocacy for options and services to meet an individual's health needs through communication and available resources to promote quality cost-effective care. The Case Manager, through direct communication with the patient, the physician, and the appropriate service personnel, assesses, monitors, and facilitates healthcare services and needs throughout the patient experience, from the ED of the acute care hospital stay to entry in post acute care, in order to optimize the outcome for all concerned. This includes validation of appropriate level of care (severity of illness), efficient and effective care delivery (intensity of services) and safe discharge to the next appropriate level of care. The Case Manager completes appropriate level of care assessments, continued stay reviews, and screening/referral for post acute levels of care utilizing established criteria and meeting local, state, and federal regulatory requirements. The Case Manager establishes a professional, resource based relationship with all concerned, demonstrating the mission, values, and vision of Catholic Health.

Responsibilities:

EDUCATION
  • Registered Nurse, licensed in New York State
  • For candidates hired after August, 2005: BSN degree or RN with BSW, BS Education, or BS in Health related field
  • Three (3) years clinical work experience in an acute care hospital setting. May substitute one year acute care hospital experience with one year residential health care experience.
  • Knowledge of admission practices and procedures, as well as related laws, regulations and guidelines pertaining to hospital, homecare, long-term care, subacute and acute rehab operations.
  • Three (3) years of experience in utilization review in an acute care setting or three (3) years of utilization review experience in a healthcare insurance company, or three (3) years of utilization review experience in a managed care setting or two (2) years' of experience in the Care Management Department of Mercy Hospital as a RN Care Coordinator/RN Case Manager is required.

If no applicants have three (3) years of experience in utilization review in an acute care setting or three (3) years of utilization review experience in a healthcare insurance company, or three (3) years of utilization review experience in a managed care setting or two (2) years' of experience in the Care Management Department of Mercy Hospital as a RN Care Coordinator/RN Case Manager, the applicants meeting the following criteria will be considered next:


  • Registered Nurse, licensed in New York State
  • For candidates hired after August, 2005: BSN degree or RN with BSW, BS Education, or BS in Health related field
  • Three (3) years clinical work experience in an acute care hospital setting. May substitute one year acute care hospital experience with one year residential health care experience.
  • Knowledge of admission practices and procedures, as well as related laws, regulations and guidelines pertaining to hospital, homecare, long-term care, subacute and acute rehab operations.
  • Prior homecare, long-term care, subacute or acute rehabilitation setting experience, or insurance utilization review experience in either a Case Manager or Nurse Manager role preferred

KNOWLEDGE, SKILL AND ABILITY


  • Possess the ability to make independent decisions when circumstances warrant such action, deal tactfully with personnel, residents/patients, family members, visitors, etc., and seek out new methods and principles and be willing to incorporate them into existing practices.
  • Possess ability to educate, inform, advocate, promote and facilitate health care options, and demonstrate the willingness to work harmoniously with a team approach. Must have patience, tact, cheerful disposition and enthusiasm and be able to relate to and work with ill, disabled, elderly, emotionally upset residents/patients and their families.
  • Must be able to read, write and speak the English language.
  • Must be able to use a computer for data entry and to send and retrieve webmail.

Special Requirements (Technical/Physical)
  • New York State PRI & Screen certification hospital and community recommended.
  • National Certification in Case Management preferred

WOKING CONDITIONS
  • Maintains a professional appearance and appropriate professional demeanor at all times.
  • Involved with residents/patients, families, visitors, government agencies/personnel, associates under all conditions and circumstances. Communicates with the medical staff, hospital and agency personnel, and other departments.
  • Willingness to work beyond normal working hours, and in other positions temporarily, when necessary.
  • Variable schedule which may include weekends and holidays. May be requested to travel to multiple hospital and community sites.
  • Subject to hostile and emotionally upset patients, family members, frequent interruptions, and travel in an automobile throughout the work day.

ENVIRONMENT
  • Normal heat, light space, and safe working environment; typical of most office jobs.
  • Occasional exposure to one or more mildly unpleasant physical conditions.



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