"Alerted.org

Part-time (48 hours biweekly)

Every Saturday & Sunday from 7a m to 7 pm

1 major & 1 minor holiday per year

General Summary

Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to support the provision of appropriate, cost effective and quality health care. Works in a team type assignment or Care Coordination Team (CCT) Model (Case Manager and Social Worker teams are assigned to patients by physician practice) to address patient care transition needs. Provides leadership in the integration of utilization and case management principles throughout the hospital.

Essential Functions:

+ Performs initial reviews for medical necessity and appropriateness of setting for the assigned case load.

+ Conducts concurrent reviews to ensure medical necessity for continued hospitalization and initiates problem-solving techniques as needed to prevent over and/or underutilization.

+ Liaisons between third party payers and the treatment team regarding the identified treatment plan in accordance with contractual guidelines or System policy.

+ Assists the patient care team with the identification and coordination of alternative treatment settings which will provide appropriate care, maintain quality of care and reduce cost.

+ Identifies conditions which require case management across the continuum. Collaborates with the members of the patient care team to identify interdisciplinary needs.

+ Makes arrangements for discharge needs (DME, Home Health, IV antibiotics, etc.) in collaboration with patients, families and care team as needed.

+ Assists with the collection and analysis of utilization patterns and denied cases.

+ Brings known or suspected problems of under-, over-, or inappropriate utilization of resources to the attention of the appropriate manager(s).

Common Expectations:

+ Prepares and maintains appropriate documentation as required.

+ Maintains established policies and procedures, objectives, quality assessment and safety standards.

+ Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Qualifications

Minimum Education:

+ Associates Degree Required

Work Experience:

+ 2 years Recent acute care experience. Required

+ Utilization management, case management, or clinical nursing specialty. Preferred

Licenses:

+ Licensed Registered Nurse Upon Hire Required or

+ Registered Nurse Multi State License Upon Hire Required and

+ Basic Life Support Upon Hire Required

Courses and Training:

+ Clearance per Child Protective Services law (11P.S. 2201) amended by PA Act 33 of 1985. Upon Hire Required

Knowledge, Skills, and Abilities:

+ Excellent interpersonal/communication skills.

WellSpan Health's vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care. As an integrated delivery system focused on leading in value-based care, we encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.

Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more - within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)

WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.