Case Manager (RN) - Good Samaritan Hospital - Full time - day

Lebanon, PA | Nursing | Tracking Code: 51281

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General Summary:
Under the general supervision of the Supervisor-Case Management, 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:
The following are essential job accountabilities:
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.
6 Makes arrangements for discharge needs (DME, Home Health, IV antibiotics, etc.) in collaboration with patients, families and care team as needed.
7 Assists with the collection and analysis of utilization patterns and denied cases.
8 Brings known or suspected problems of under-, over-, or inappropriate utilization of resources to the attention of the
appropriate manager(s).


Required Skills

Utilization review and care coordination with the hospital setting


About WellSpan
Quality of Life

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization is comprised of a multispecialty medical group of more than 1,200 physicians and advanced practice clinicians, a regional behavioral health organization, a home care organization, six respected hospitals, more than 15,000 employees, and 140 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.

Quality of Life
Quality of Life

Formed in 1813, Lebanon is a quaint city of 25,700 residents. The area, rich in heritage and the small-town charm of yesteryear, features sites on the National Register of Historic Places, museums, scenic parks and recreation facilities, performing arts theaters, artists' studios, a farmers' market and dining establishments for all tastes.

Life in Lebanon County offers affordable housing and options for pursuing higher education. Residents can find local employment in manufacturing, retail, arts and entertainment, healthcare and service sectors. Located in southcentral Pennsylvania, Lebanon is within an easy driving distance to Harrisburg, Lancaster, Reading and York. (Patient population: 140,000)

Equal Opportunity Employment

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.

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