Case Manager - Per Diem - Day

Overview Hackensack Meridian Health Virtual Interview Confirmation **PLEASE READ Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Case Manager provides assessment, care planning and coordination, and advocacy to patients and their families. Assists with the patient flow through the continuum of care in a timely manner. The case manager follows guidelines and regulations according to level of care criteria (Medicare, Medicaid, HMO's, etc). Responsibilities A day in the life of a Case Manager at Hackensack Meridian Health includes: Evaluates all patients for appropriateness of admission and level of care within 24-48 hours. Initiates discharge plan within 24-48 hours of admission. Discusses initial plan of care with MD. Discusses and reviews initial plan of care with patient/family. Ensures and follows CMS protocols, IM letters and all HQSI letters. Documents in all required areas and ensures required documentation elements are all included. Participates in daily multidisciplinary rounds. Maintains communication with a multidisciplinary team through the continuum of care. Provides daily clinical reviews as required. Maintains ongoing communication with physicians and patients/families to ensure plan of care is appropriate and expedited. Ensures clinical reviews are communicated to insurance companies to ensure payment. Refers cases, as needed, to physician advisor, denials team and/or other appropriate team members. Manages denials concurrently and communicates and documents all outcomes and actions taken. Communicates identified issues to appropriate departments for problem resolution using variance tracking. Actively participates and assists in departmental PI goals and patient satisfaction initiatives. Other duties and/or projects as assigned. Adheres to HMH Organizational competencies and standards of behavior. Qualifications Education, Knowledge, Skills and Abilities Required: Graduate of an accredited Nursing Program. Related Case Management and Nursing experience. Knowledge of CM, Utilization Review Discharge Planning and Coordination of Care. Excellent computer skills Education, Knowledge, Skills and Abilities Preferred: 5 Years of experience as an RN in an acute care setting. Familiar with Access programs. Licenses and Certifications Required: NJ State Professional Registered Nurse License. Starting Minimum Rate Minimum rate of $44.30 Hourly Job Posting Disclosure HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to: Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness. Experience: Years of relevant work experience. Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training. Skills: Demonstrated proficiency in relevant skills and competencies. Geographic Location: Cost of living and market rates for the specific location. Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization. Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered. Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts. In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits. #J-18808-Ljbffr Hackensack Meridian Health