Description
General Summary of Position
MedStar Health is looking for a Clinical Case Manager to join our team!
The Clinical Case Manager monitors the care and services delivered to selected patient populations during the acute hospital stay, promotes effective utilization of resources, and assumes a leadership role with the interdisciplinary team to achieve optimal clinical and resource outcomes for the acute, and posthospital phases of care. Develops and maintains a positive work climate and supports the overall team effort of the health system. The functions are performed in accordance with all applicable laws and regulations and MedStar Georgetown University Hospital's philosophy, policies, procedures, and standards.
Join one of the largest healthcare systems in the Baltimore-Washington metro region, also recognized as one of the "Healthiest Maryland Businesses". Apply today and learn how MedStar Health can be your next great career move!
Primary Duties:
Assesses, facilitates, and monitors the care plan with the patient and/or family/significant other. Communicates the need, or lack of, continued hospitalization and ensures patient understanding of third-party payer guidelines.
Conducts concurrent chart review of selected patient populations, assesses the appropriateness of the level of care, diagnostic testing and clinical procedures, quality and clinical risk issues, and completeness of medical record documentation.
Reviews all patient admission data within the designated times to determine the suitability of the level of care in accordance with established guidelines. Identifies issues/problems and makes appropriate recommendations. Communicates with patients, families/ significant others, medical staff, caregivers, and third-party payers, as necessary.
Coordinates care within MGUH (MedStar Georgetown University Hospital) and other settings by monitoring and overseeing the continuum of clinical care, ensuring necessary meetings are held with patient/family and the interdisciplinary team to coordinate treatment and discharge plans. Arranges discharge-planning referrals as ordered by patient's physician.
Serves as a facilitator/advocate for patients and families in the resolution of problems related to the established plan of care and procurement of services. Produces case documentation in approved manual or electronic format while maintaining required departmental standards and protocols. Participates in the development and standardization of improved pathway and best practice scenarios.
Qualifications:
Master's degree in social work or bachelor's degree in nursing.
3-4 years Clinical experience in an acute care setting.
RN (Registered Nurse) State Licensure and/or Compact State Licensure or LCSW in the District of Columbia.
Specialty certification preferred.
Advanced Degree preferred.
Utilization management and/or case management experience preferred.
Primary Duties and Responsibilities
Minimum Qualifications
Why MedStar Health?
At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through:
- Strong emphasis on teamwork—our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
- Strategic focus on equity, inclusion, & diversity—we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
- Comprehensive total rewards package—including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
- More career opportunities closer to home—as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.
MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.
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