Nurse Care Manager

Nurse Care ManagerNMC is currently recruiting a Nurse Care Manager, in Case Management. The position is full-time, hours primarily 8:00 a.m. - 4:30 p.m.; weekends as needed. Northwestern Medical Center's mission is to provide exceptional health care to our community. Join our high reliability team! With "people" as one of our core values, valuing our employees is a top priority for Northwestern. We care about our employees, their families, and their overall health & well-being. We are proud to offer a generous benefits package, with recognized national carriers, designed to help our people stay healthy, balance work & life responsibilities, protect your assets & plan for a secure financial future.Hiring Range: $35-$55.94This position is part of a bargaining unit represented by a labor union. Wages, benefits, and certain terms and conditions of employment are governed by the applicable collective bargaining agreement.JOB SUMMARY:Conduct individualized concurrent clinical evaluations of patients, their health needs, and concerns; review patient medical record for medical necessity, develop personalized action plans, provide education, and issue referrals for post-acute care; monitor patients' progress in meeting established goals and modify care plans accordingly. Provide clinical information to health insurers as required. Work closely with interdisciplinary care team and technology to identify high-risk, complex patient cases; manage care, provide care planning, referral management, post-discharge planning, and coordinating community-based and transitional care. Develop a cohesive and strong team-oriented relationship with physicians, nurses, and other healthcare professionals; evaluate and report on patient health outcomes and work in partnership with interdisciplinary healthcare team to facilitate the best in patient care. Direct discharge planning process in support of treatment adherence and medication compliance; assist with transitions for patients discharged from an in-patient hospital to post-discharge care; include patients and caregivers in transition of care planning; Advocate for decreased hospital stay when appropriate. Guide, intervene and advocate on behalf of patients, their caregivers and/or families regarding navigating and comprehending the healthcare system; coordinate resources in the community to ease transition. Maintain accurate and timely records of all patient-related interactions. Work in an intensive, fast-paced environment with minimal supervisionPRE-REQUISITES:Education: Graduate of an accredited school of licensed practical nursing or registered nursing with current licensure as a Registered Nurse or Licensed Practical Nurse in the State of Vermont. BSN or MSN strongly preferred.Experience: Three years in a hospital &/or clinic setting preferred. Utilization management and/or case management, community care management experience preferred. Certified Case Manager preferred.Other Skills:Certifications:RELATIONSHIPS:· Reports To: Manager, Case Management· Supervises:· Other Contacts: Patients, families, hospital staff, community agencies, providers and their staffSCOPE:· Machinery or Equipment Used: Computer, basic office equipment· Physical Demands: Moderate physical activity, requires manual dexterity, visual acuity and mobility.· Working Conditions: May be exposed to infectious diseases.? contact with patients under a wide variety of circumstances and crisis situations.· Required Protective Equipment: PPE as patient situation or condition dictates according to policy.ESSENTIAL FUNCTIONS:Collaborates with internal staff and outside agencies to meet the needs of the patient and their families.Collaborates with DCF/APS for issues regarding children and vulnerable adults and files appropriate reports as required by lawAssists patients of all ages to provide information on resources/services availableUtilizes community service providers to maximize the patient's ability to function in the communityMakes appropriate referrals to social service agencies related to financial concerns for adult patientsSupports patients and families during times of transition.Coordinates support for post partum mothers and their infantsProvides information to patients and families regarding end of life care and optionsSupports the emotional needs of patient/family when discussing and/or planning placement in a skilled nursing facility or other long-term care solution respecting feelings regarding their loss of independenceSupports emotional and clinical needs of chronic disease management, as well as diagnosisParticipates in discharge planning and Care Coordination.Assists patients with identifying support systems and services post dischargeCoordinates with & contributes to inpatient discharge planning activities to ensure patients' needs are being met, roadblocks/barriers to discharge are addressed, appropriate services/supports are offeredCommunicates with long-term care facilities and home health agencies to facilitate transition back to community settingProvides information to patient and family that is age specific and appropriate for their level of understanding.Acts as a liaison between provider and patient/family to answer questions, clarify issues, and gather informationProvides information to patients/family to improve their understanding of medical recommendationsConducts patient record review to determine appropriateness of admission based on established criteria.Communicates with providers to ensure appropriate level of care, efficient use of resources, payor requirements, and plans for discharge.Collects data related to LOS, denied days, resource consumption and patterns and explores strategies to manage utilization and decrease variation.Updates insurance providers as needed regarding plan of care.Equal Employment Opportunity StatementNorthwestern Medical Center is an Equal Opportunity Employer. We are committed to creating and maintaining a workplace that values diversity, inclusion, and belonging. All employment decisions are made without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.Northwestern Medical Center is dedicated to fostering a respectful, inclusive, and supportive work environment where all employees have the opportunity to contribute, grow, and succeed. We encourage qualified individuals from all backgrounds and experiences to apply.Reasonable accommodations are available for qualified individuals with disabilities throughout the application and employment process. Applicants requiring accommodation are encouraged to contact Human Resources for assistance.Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.