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Care Management Representative
at Saratoga Hospital
Job Status: Full Time
Job Reference #: 6776
Saratoga Springs, NY
Work Hours: 8am-4:30pm
| I. Summary of Position|
This job description provides information essential to understanding the scope of the position and is not intended to be an exhaustive list of skills, efforts, duties, responsibilities or working conditions associated with the position
|This nursing position is responsible for providing care coordination, comprehensive discharge planning, daily rounding with interdisciplinary team, utilization review/management, readmission avoidance action plan strategies, care transitions coordination and strategic plans for the Collaborative Practice Groups under the guidance of the Director of Care Management. The Care Management Representative participates in a collaborative process which assesses, plans, implements, coordinates, monitors and evaluates the options and services for a patient's individual health needs under the Scope of Service for the department. Provides linkages, referrals, coordination, and follow-up for identified patients and those who qualify for Health Homes. Coordinates follow up appointments with patient's Primary Care Physician /Patient Center Medical Home/ Health Home based on risk status. Responsible for daily operations to coordinate high quality cost effective care at Saratoga Hospital. Responsibilities include meeting all compliance and regulatory agency guidelines. Strives to incorporate the philosophy and mission of the hospital and its goals of rendering quality care management services. Is a critical thinker and problem solver to resolve challenges and barriers to achieve care management goals and safe disposition of patient across the care continuum. Possesses strong interpersonal skills to work with care management team and other interdisciplinary team members to reach quality outcomes. Care Management average patient case load is 20-25 pts:1 care manager and may have assistance with other team members such as social workers on dual plans and nursing facility placements.|
| II. Primary Job Responsibilities|
These requirements are representative, but not all-inclusive, of the knowledge, skill, and ability required of the position. Primary job responsibilities constitute approximately 90% of the positions work. To be successful, individuals must be able to perform each essential responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions outlined in this position description.
|III. Additional Responsibilities|
Under the direction of the Director of Care Management may have opportunities to work with legal counsel and other agencies such as Regulatory Agencies and Mental Hygiene Legal services to achieve planning requiring legal guidance to achieve safe patient outcomes.
|IV. Supervisory Responsibilities|
|V. Minimum Qualifications|
|Education, Training & Experience||BSN preferred (or matriculating towards degree achievement)|
Minimum of 3 years acute care hospital experience
Knowledgeable of New York State and Federal Entitlement Programs and regulatory requirements.
|Certifications / Licensure||Current RN nursing license|
PRI Certification preferred
CCM Certification preferred
|VI. Required Skills and Attributes|
|Able to function independently|
Able to prioritize and multitask
Leads and works effectively with social work team and care management department
Strong interpersonal skills, able to critically think and intervene in crisis and complex family dilemmas.
Effective verbal and written communication skills
Skilled in Meditech programming and Microsoft products
Open to constructive feedback
Possesses critical thinking skills for problem solving
|VII. Patient Populations Served (Check all that apply)|
|X||Neonates 1- 30 days||X||Adults 19-70 years|
|X||Infants 30 days – 1 year||X||Geriatrics 70 +|
|X||Children 1-12 years||No patient contact|
|X||Adolescents 13-18 years|
|VIII. Work Environment/Working Conditions|
|The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.|