Nurse Care Manager

Monitors the patient care process and collects data to evaluate and improve care and collaborates with physicians and other health care workers to provide comprehensive care including health risk appraisal, health promotion and clinical outcome studies. Educates payers, providers and the public and serves as the information source regarding state and national health care trends; initiatives, which enhance the provision of, care and ensure efficient resource utilization.

Key Responsibilities and Expectations Collaborates with all members of the interdisciplinary team and the patient to implement the plan of care. Monitors the patient’s progress, intervening as necessary and appropriate to ensure the plan of care and services provided are patient focused, high quality efficient and cost effective. Addresses and resolves system barriers impeding diagnostic or treatment progress.

Proactively identifies and resolves delays and obstacles to discharge in conjunction with the Associate Care Manager. Ensures/maintains plan consensus from patient/family, physician and payer. Mobilizes resources and coordinates the effort to the health care team to achieve a positive patient transition to appropriate next level of care.

Conducts assessment of patients on assigned unit(s) to develop a care management discharge plan of care. Gathers information from patients, physicians, and other pertinent members of the healthcare team. Plans and develops specific objectives, goals and actions designed to meet the patient’s needs as identified through the assessment process.

Utilizes hospital approved review criteria to ensure appropriate bed status. Identifies “at risk” populations using approved screening tools and follows established reporting procedures. Ensures appropriate admission status is documented.

Manages all aspects of discharge planning for assigned patients in collaboration with interdisciplinary team by meeting directly with patient/family to assess needs and develop an individualized discharge plan. Delegates the execution of the discharge plan to Associate Care Manager. Refers appropriate cases for Social Worker intervention based on department criteria.

Documents relevant discharge planning information in Allscripts according to department standards. Communicates plan of care to patient and their family providing updates and reassesses the plan of care to determine effectiveness. Completes appropriate care management documentation.

Evaluates the plan of care at appropriate intervals to determine effectiveness in meeting outcomes and goals. Works with nursing and other disciplines to ensure that discharge needs, including teaching, are met. Administers Utilization Management activities for assigned patients.

Applies approved utilization criteria to monitor appropriateness of admissions and continued stays, and documents findings based on department standards. Monitors length of stay (LOS) and ancillary resource use on an ongoing basis and takes action to achieve continuous improvement. Addresses appropriate channels for resolution of issues in order to continually improve patient outcomes.

Collects and analyzes outcome data. Identifies less than optimal outcomes and makes recommendations for outcome and process improvement. Assumes leadership role with interdisciplinary team to achieve optimal clinical, satisfaction and resource outcomes.

Formulates and evaluates educational strategies for patients and families. Serves as patient advocate by assuring care rendered is appropriate, timely and confidential. Collects patient care information and accurately completes and updates when required the Patient Review Instrument (PRI) and New York State SCREEN to facilitate discharge to skilled nursing or other health care facilities.

Provides verbal/written notification of denial of benefits to the patient and/or patient representative and provides education and support in understanding the process.

Position Qualifications

Minimum Required

Associate’s in Applied Science in Nursing with a minimum of two years of experience in acute/tertiary facility NYS Registered Nurse

Preferred

Bachelor’s of Science in Nursing with 3 years of experience in acute/tertiary facility Five years experience in acute/tertiary facility

Employee Benefits at United Health Services When you work at United Health Services, you become part of our family. We’re proud to offer competitive benefits and compensation to our employees who make an impact every day. Health, dental, and vision insurance Voluntary benefits, including cancer, pet, and life insurance 403(b) retirement plan with company match model Immediate accrual of paid time off Wellness program rewards and insurance discounts Employee Assistant Program (EAP) counseling and concierge services Free, extensive online training through HealthStream

About United Health Services United Health Services is a not-for-profit healthcare system serving more than 500,000 people in Upstate New York’s Southern Tier region. We offer integrated healthcare services across 60 locations, including four hospitals, three walk-in centers, and 22 primary care offices, in addition to home care services and senior living facilities. The United Health Services system employs more than 6,300 people and comprises 600+ providers who are all committed to providing and supporting the delivery of exceptional patient care.

United Health Services employees and providers are “LOVED!” This means we’re Living Our Values Every Day. Here, you’ll join a team that is dedicated to values-based, coordinated patient care. Every day, we outwardly live our Values of Compassion, Trust, Respect, Teamwork, and Innovation.

About New York’s Southern Tier As an employee of United Health Services, you’ll call the Southern Tier, or more specifically, the Greater Binghamton area, home. Known for entertainment and restaurants, craft brews, outdoor experiences, minor-league sports, family-friendly events, and a keenness for local history (like our connection to the Twilight Zone and our six antique carousels), Greater Binghamton offers something for everyone. We’re a short drive away from the Finger Lakes region in Central New York, three hours from New York City, and just shy of four hours from Niagara Falls, Canada.

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United Health Services in an Equal Opportunity Employer. United Health Services, Inc. and the members of the UHS System neither are affiliated with, sponsored, endorsed nor approved by, nor otherwise associated with, Universal Health Services, Inc. (NYSE: UHS), UHS of Delaware, Inc. nor their affiliates, which can be found at www.uhsinc.com.