Case Manager (RN) - Day

York, PA | Nursing | Tracking Code: 66269

 

Full time (80 hours biweekly)

Monday - Friday

8am - 4:30pm

 

Job Description:

RN  Under the general supervision of the Supervisor-Case Management, Case Manager performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to support the provision of appropriate, cost effective and quality health care. Works in a team model (Case Manager and Social Worker teams are assigned to patient care areas) to address patient discharge needs. Provides leadership in the integration of utilization and case management principles throughout the Hospital.

 

Duties and Responsibilities

 

  1. Performs initial reviews for medical necessity and appropriateness of setting for the assigned case load.
  2. Conducts concurrent reviews to ensure medical necessity for continued hospitalization and initiates problem-solving techniques as needed to prevent over and/or under utilization.
  3. Liaisons between third party payers and the treatment team regarding the identified treatment plan in accordance with contractual guidelines or System policy.
  4. Assists the patient care team with the identification and coordination of alternative treatment settings which will provide appropriate care, maintain quality of care and reduce cost.
  5. Identifies conditions which require case management across the continuum. Collaborates with the members of the patient care team to identify interdisciplinary needs. 6Makes arrangements for discharge needs (DME, Home Health, IV antibiotics, etc.) in collaboration with patients, families and care team as needed.
  6. Assists with the collection and analysis of utilization patterns and denied cases.
  7. Brings known or suspected problems of under-, over-, or inappropriate utilization of resources to the attention of the
  8. appropriate manager(s).

Qualifications

  • Minimum Experience:
    • 2 - 3 years recent acute care
  • Minimum Education:
    • Associate's Degree
    • Bachelor's degree preferred
  • Preferred Field Of Expertise:
    • Utilization management, case management, or clinical nursing specialty
  • Required Certification:
    • Registration and current RN license in PA
Heather Torres
Heather Torres
Sr. Talent Acquisition Consultant
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Why WellSpan Health?

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization comprises a multispecialty medical group of more than 1,600 physicians and advanced practice providers, a regional behavioral health organization, a home care organization, eight respected hospitals, more than 20,000 employees and 200 patient care locations. WellSpan is a charitable, mission-driven organization committed to exceptional care for all, lifelong wellness and healthy communities. We are committed to transforming the health of the communities we serve and to educating the next generation of clinicians, staff and leaders.

Employment Benefits

  • Sign-on incentives for new employees (click here for details)
  • Medical, dental and vision insurance
  • Life and accidental death insurance
  • Supplemental life insurance
  • Retirement savings plan
  • Paid time off (PTO)
  • PTO bridging
  • Short-term disability
  • Educational assistance
  • Forgivable loan
  • Flexible spending
  • Credit union
  • Employee recreational activities
  • Childcare
  • Complimentary medicine discounts

Diversity & Inclusion

Welcome. Respect. Value.

Wellspan Health believes that diversity includes all the human characteristics that make each of us similar as well as different. We strive to make every person feel welcomed, respected, and valued while creating a safe and inclusive environment where we all have the individual freedom to express our uniqueness in a respectful manner.

WellSpan Health is an equal opportunity employer. Employment selection and related decisions are made without regard to sex, race, age, disability, religion, national origin, color or any other protected class. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more — within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)