About this opportunity
Children's Hospital Of The King's Daughters lists this Case Manager opportunity in norfolk, Virginia. Review the employer’s description below for duties, qualifications and application requirements.
Job description
nnGENERAL SUMMARY
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nnThe Case Manager is responsible for coordinating the case management care plan to meet the individual/caregiver needs, promoting quality, and cost-effective outcomes. This position involves identifying and resolving barriers that may hinder effective patient care and patient progression to a safe discharge in a timely manner. The Case Manager is responsible for the facilitation of clinically pertinent reviews on patient admissions for continued stay reviews including completion of certifications. Reports to department leadership.
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nnESSENTIAL DUTIES AND RESPONSIBILITIES
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nnEducates and empowers individual/caregiver toward self-care and independence.
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nnCollaboratively works to carry out the process of assessment, planning, facilitation, care coordination, evaluation and advocacy options and services to meet the individual’s and family’s comprehensive health needs.
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nnAssesses the patient’s plan of care and develops, implements, monitors, and documents the utilization of resources and progress of the patient through their care.
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nnInterfaces with managed care organizations, external reviewers, and other payers to ensure that the admission and continued stay standards are in compliance with Centers for Medicare and Medicaid Services (CMS) standards.
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nnFacilitates options and services to meet the patient’s health care needs.
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nnPerforms all other duties as assigned.
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nnLICENSES AND/OR CERTIFICATIONS
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nnPreferred Licenses and/or Certifications
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nnRegistered Nursing License in the State of Virginia or Registered Nurse (RN) holding a valid Compact State license preferred.
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nnCase Management Certification preferred.
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nnMINIMUM EDUCATION AND EXPERIENCE REQUIREMENTS
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nnRequired Education and Experience
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nnRegistered Nursing License in the State of Virginia, Registered Nurse (RN) holding a valid Compact State license or Master of Social Work (MSW) from an accredited college / university required.
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nnThree years or more acute care experience required.
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nnMust provide record of all licensures, certifications, training, and educational requirements at the time of hire.
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nnContinuous re-certification and/or maintenance of state licensures, certifications, training, educational and application requirements is required during employment.
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nnPreferred Education and Experience
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nnBachelor of Science in Nursing (BSN) preferred.
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nnMust provide record of a completed degree or academic transcript from an accredited program, college, or university at time of hire.
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nnOne year or more case management / care coordination experience preferred.
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nnThree years of acute care experience in pediatric field preferred.
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nnRequired Knowledge, Skills, and Abilities
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nnProfessional knowledge of area of responsibility to direct planning and implementation of individualized service plan for eligible children with special health care needs to include medical care, social, developmental, educational, vocational, and financial aspects.
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nnPossess the ability to plan, manage and establish a professional working environment within areas of responsibility.
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nnCapable of identifying problems and implementing solutions for operational and organizational issues.
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nnDemonstrates an understanding of the authorization process with Medicaid and other insurances as well as knowledge of Medicaid regulations.
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nnHighly motivated, enthusiastic team player who takes initiative.
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nnStrong organizational skills with attention to detail and commitment to accuracy.
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nnPossess strong verbal and written to adequately describe patient’s clinical presentation and progress in a comprehensive and concise manner.
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nnStrong interpersonal skills as well as, the ability to interact with and build collegial relationships with diverse individuals.
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nnProficiency and technical aptitude with the use of Adobe Acrobat and MS Office products, including Excel, PowerPoint, Outlook, and Word.
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nnPreferred Knowledge, Skills, and Abilities
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nnKnowledge of utilization review and hospital finance processes preferred.
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nnWORKING CONDITIONS
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nnNormal office environment with little exposure to excessive noise, dust, temperature and the like.
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nnPHYSICAL REQUIREMENTS
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nnClick here to view physical requirements. (
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Worksite address
norfolk, VA, 23500, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.