Clinical Case Manager

SUMMARY

The Center utilizes a universal, evidence based, research informed, and policy driven approach to enhanced care coordination that not only meets the interrelated medical, developmental, behavioral, and social needs of children, but enhances the care giving capacity of families.

Clinical Case Manager: The Case Manager is committed to providing high quality patient/family care through the early identification/assessment/acquisition of services and resources required for safe and sustainable discharge plans. The Case Manager is a critical partner in the health care team and contributes to the patient family experience by meeting the medical discharge needs of the family. 
 

ROLE RESPONSIBILITIES

Discharge Planning

Responsible for discharge planning activities; with a focus on increasing patient outcomes, reducing readmission risks, monitoring avoidable days and gmLOS

Performs initial needs assessment, individualized plan of care and determines case management level of care.  After consultation, case manager performs ongoing evaluation and documents patient progress and discharge needs 

Promotes continuity of care and cost effectiveness through the integration of functions of case management and discharge planning

Collaborates/serves as the link with/between inpatient, outpatient, and community team members (Social Work and Care Coordination) to provide seamless transitions throughout the care continuum 

Attends daily medical rounds as needed.

Case manager assists with appropriate transfer/placement for higher/lower levels of care (medical/psychiatry)

Performs readmission assessments, provides letters of medical necessity, obtains prior authorizations as indicated

Screens patient populations for population health care needs, assist patients and families in navigating the health care system, coordinating referral services including skilled and shift nursing, durable medical equipment, infusion and enteral supplies. 

Additional Responsibilities:

Empower families to direct the care of their children within the care delivery system) by formulating a care plan that promotes self-advocacy, increases awareness of appropriate resources and how to access them, and promote/identifies culturally relevant services

Identify gaps in care/resources and address issues that negatively impact access to care, services, and resources

Function as a change agent, advocate, and resource person for family and healthcare team to identify and resolve performance improvement issues within the system

Involvement in Magnet activities

Engagement in Center for Care Coordination activities that will create opportunities for broad impact on child/family health and well-being (i.e. research, innovation, forums, presentations)

Commitment to ONE TEAM Culture

Position Specific Role Responsibilities

Demonstrate knowledge about population-specific differences and varying needs of patients in, specific populations from neonate through adolescence and applies that knowledge in practice.  Demonstrate cultural sensitivity in all interactions with patients/families and co-workers
Facilitate effective communication within the health care team to promote continuity of care
Possesses a strong commitment to patient and family centered care.

Demonstrates support for the mission, values and goals of the organization through behaviors that are consistent with the Connecticut Children’s standards. 

EDUCATION  and/or  EXPERIENCE  REQUIRED

BSN Required. Pediatric experience preferred. 

At least 3 yrs. experience in a healthcare setting required. 

Position Specific Job Education and/or Experience

Previous experience in Case Management, Discharge Planning preferred

Position Specific Job License and/or Certification Required

Current State of Connecticut Registered Nurse licensure required. 

Case Management Certification preferred.

KNOWLEDGE, SKILLS AND ABILITIES  REQUIRED

KNOWLEDGE:

Demonstrate working knowledge of how to interpret and apply medical care criteria.

Knowledge of community resources, treatment options, home health availability, funding options and speci