Case Manager, Paramus, Days
 Valley Health System | |
 United States, New Jersey, Paramus | |
 Apr 01, 2025 | |
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POSITION SUMMARY:
Coordinates the care for observation patients in the Clinical Decision Unit (CDU) from both a discharge planning and utilization review perspective. Performs concurrent utilization review activities on all patients within the assigned caseload. Collaborates and educates the medical staff on appropriate utilization review guidelines and documentation in accordance with CMS regulations and Commercial payors guidelines. Monitors and intervenes on LOS, resource utilization and denial management/ prevention within the assigned caseload. To coordinate and facilitate patient care through the Valley Hospital Health Care System as it relates to a multidisciplinary approach to patient care and utilization of resources. EDUCATION: Bachelor's degree (BSN) in nursing required. Bachelor's degree required. ANCC case management certification preferred. Expectations: achieve ANCC case management certification within two years (effective 2016), or when requirements for sitting for the e EXPERIENCE: Minimum 5 years' experience in clinical nursing, minimum of 3 years in case management/ utilization. SPECIAL SKILLS: Registered Nurse, Licensed in State of New Jersey, Current acute care clinical knowledge with broad-base medical / surgical background. Demonstrates effective interaction and communication skills. Strong critical thinking, clinical reasoning skills and effective problem-solving. Ability to perform work accurately and pay attention to details, often changing from one task to another without loss of efficiency or composure. Ability to function competently in stressful situations and changing work environment, Ability to work collaboratively within the health- system with patients and families; and with multidisciplinary team members (i.e. , physicians, Rehab, Respiratory, DI, Lab, etc.). Ability to utilize effective time management to set priorities, perform job related responsibilities, and respond quickly to emergency situations. Ability to use critical thinking and clinical reasoning skills effectively problem-solve and provide case management services. Job Location The Valley Hospital-ParamusShift Day (United States of America)EEO Statement Valley Health System does not discriminate on the basis of ancestry, age, atypical hereditary cellular or blood trait, civil union status, color, creed, disability, domestic partnership, gender, gender identity or expression, familial status, genetic information, liability for service in the Armed Forces of the United States, marital status, medical condition or illness, mental or physical handicap, national origin, nationality, perceived disability, pregnancy, race, refusal to submit to genetic testing or make available results of such tests, religion, sex, sexual orientation, veteran's status or any other protected basis, in accordance with all applicable Federal, State and Local laws. This applies to all areas of employment, including recruitment, hiring, training and development, promotion, transfer, termination, layoff, compensation, benefits, social and recreational programs, and all other conditions and privileges of employment. | |