Case Manager II

What You Will Do:Case Manager II Full-time - Rotating Shift UMMC - Baltimore, MD UMMC, the System''s flagship academic hospital located in Baltimore City, is ranked as 2 both in the state of Maryland and Baltimore Metro area. UMMC also ranked 44 nationally for the Ear, Nose, and Throat (ENT) specialty and as ''High Performing'' in Cancer, Gastroenterology and GI Surgery, Orthopaedics, Pulmonary and Lung Surgery, and Urology services. Earlier this year, the University of Maryland Children''s Hospital, located at UMMC, was ranked as one of the ''Best Children''s Hospitals for Cardiology and Heart Surgery'' for the fifth consecutive year. ''It is an extremely proud moment for our System to have three of our member organization hospitals recognized as among the best in Maryland,'' said Mohan Suntha, MD, MBA, President and Chief Executive Officer of UMMS. ''Our team members work tirelessly to bring the advances of academic medicine to patient care at the bedside, and the prestigious U.S. News rankings are validation of our efforts to deliver the highest quality and safest care possible.''University of Maryland Medical Center (UMMC) has achieved Magnet status in recognition of the hospital nursing excellence. UMMC is a teaching hospital with 757 beds based in Baltimore, Maryland, that provides the full range of health care. It has more than 35,000 inpatient admissions and 165,000 outpatient visits each year. The R Adams Cowley Shock Trauma Center (also known as Shock Trauma) is the world''s first center dedicated to saving lives of people with severe, life-threatening injuries sustained in motor vehicle collisions, violent crimes and other traumatic incidents.Our vision is to provide high value and compassionate care, improving health in Maryland and beyond, educating future health care leaders and discovering innovative ways to advance medicine worldwide.JOB SUMMARY: Under general supervision, provides utilization management, care coordination, and discharge planning for an assigned patient case load. This role is patient focused, outcome-oriented, and based on general and specialty professional standards, and functions within a multi-disciplinary practice model. The scope of the role extends beyond University of Maryland System boundaries and includes authority and accountability to intervene on the behalf of identified patients wherever care is required.Principal Responsibilities and Tasks:The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.Assesses the needs of individual patients within an assigned case load for care coordination, discharge planning, and utilization management services Facilitates early referral to physical therapy, occupational therapy, social work, risk management, patient advocacy, post-acute services, and quality management when needed. Refers clinical issues and lapses in standards of care to appropriate parties.Creates case management care plans for assigned patients. Comprehensively assesses patients'' requirements for services. Extensively assesses patients'' organizational, and payer needs with regard to meeting clinical and financial goals, and patient/provider satisfaction.Facilitates multi-disciplinary collaboration. Collaborates with colleague case managers in providing coordination of care. Works with a multi-disciplinary team to develop a treatment plan, including contingency plans. Contributes to problem solving within the team through communication, collaboration, data collection, obtaining consensus, and evaluating outcomes of treatment options. Implements strategies for case management care plans: Intervenes on behalf of the patient and organization to achieve above stated forms patients and families about services and alternatives and assists them in making informed care decisions.Manages implementation of the treatment plan across the in-patient and out-patient continuum.Facilitates the discharge planning process to assure timely referral, discharge, and access to community services.Negotiates funding options from payers.Continuously monitors and evaluates services and outcomes for assigned patients. Determines extent to which clinical, satisfaction, and financial goals are met.Creates summaries for review with the multi-disciplinary team and for outcomes reporting to executive management, utilization management and department heads.Demonstrates value of program through quantitative evidence of cost-reducing, quality enhancing interventions on the behalf of patients and the organization. As a Registered Nurse at UMMC, you''ll experience:A supportive and collaborative work environmentAn Achievable Professional Advancement model: Opportunities to progress in function, skills, and pay through our achievable promotion schedule; The opportunity to work in a specialized care environment at an Academic Medical Center with a nursing centered care model and Magnet Designation;A comprehensive benefits package including health, vision and dental coverage including prescription drug coverage, Tax-Free Savings Plans and more!A highly competitive wage scale: Annual merit increases and a base wage scale that is measured against to market standards.Generous tuition reimbursement of up to $10,000 per year for your graduate degree at University of Maryland School of Nursing.Located in downtown Baltimore near the Inner Harbor and Camden Yards, you won''t find a more vibrant place to work! What You Need to Be Successful:Licensure as a Registered Nurse (RN) in the state of Maryland, or eligibility for licensure is required. Bachelor''s degree is also required. A health-related Master''s degree and certification as case manager are both preferred.One year of experience in case management and knowledge of payer mechanisms and clinical utilization management is preferred.Two years'' experience in acute care required, four years clinical nursing experience preferred. Additional experience in home health, ambulatory care, and/or occupational health is preferred.Four years clinical experience which includes demonstrated effectiveness in coordinating care for a broad range of high risk and complex patients is required. Experience in acute care as well as home health, ambulatory care, and/or occupational health is preferred.We are an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

Created: 2025-11-15