Registered Nurse - Care Management

Req ID:205936Recruiter:Jade N CharokoposShift: AnyEmployment Status:Regular - Full TimeSalary Grade: S 18For more information about CHOP''s currentFiscal Year Compensation Plan Guidelinesplease click hereAbout UsWe''re seeking breakthrough makers! Children''s Hospital of Philadelphia was built on the belief that we can change lives. Today, in every role throughout our hospital, research institute and care network, the 22,000 members of our workforce are finding new ways - big and small - to make a difference for the patients and families we serve.If you are ready to challenge yourself, be inspired and grow - no matter what your role - you just may be the kind of breakthrough maker who will thrive at CHOP.CHOP is proud to share that we are ranked No. 1 on Forbes'' 2022 list of America''s Best Large Employers!Job SummaryThe Registered Nurse (RN) Care Management Coordinator or ''RN Care Manager'' provides care management services to a panel of medically complex patients or populations of patients who have risk factors that are amenable to care management interventions. The RN Care Manager may be assigned regionally to support one or more CHOP primary care practices, may be assigned to the care of patients who receive primary care outside of the CHOP Care Network, or a specialty care disease-specific Care Management model. S/he serves as an advocate for patients and their families and assists them to navigate the health care system. The RN Care Manager facilitates the continuity of a patient''s care by functioning as a liaison between primary care providers (PCPs), outpatient specialty care providers and inpatient care teams, as well as payers, medical equipment suppliers, home care providers, subacute and chronic care facilities and community resources. S/he collaborates with ambulatory, emergency department and inpatient care teams with the goals of optimizing communication among care providers, promoting seamless transitions between care settings and facilitating the appropriate use of health care resources.Job ResponsibilitiesPracticeGeneral care management responsibilities:Identify patients in need of care management and maintain a patient database.Provide care management services to an assigned panel or designated population of patients and their families.Develop and maintain patient-centered, intra-disciplinary, longitudinal plans of care and monitor patients'' progress toward care plan goals.Advocate for patients and families and promote communication and collaboration to keep all care team care members informed of patients'' care needs and to ensure that patients access and benefit maximally from available health care resources.Facilitate transitions across care settings.Assist patients and families with access to health care services as needed, including collaboration with payers.Teach, coach and counsel patients and their families to build independence and skills for self-management.Monitor and evaluate patients'' outcomes and communicate outcomes to health care teams.Use information systems to document and track care management interventionsTransfer patients to higher or lower levels of care management support as appropriate.Collaborates with patient and family health care providers and agencies using a multidisciplinary and holistic approach to help the patient and family set realistic and achievable goals to achieve the desired outcomes.Utilizes professional and community knowledge and influence to obtain resources in the most cost-effective manner to best meet the patient''s developmental, physical, psychosocial and financial needs.Researches, selects and promotes adaptation of best practice findings to ensure quality patient care and optimal outcomes.Adapts behavior as needed to the specific patient population, including but not limited to respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style.Job Responsibilities (Continued)Practice (continued)Outpatient care management responsibilities:Communicate regularly with PCPs and relevant specialists regarding acute and chronic patient care issues and intra-disciplinary care plans.Review medical records prior to encounters and participate in outpatient visits as necessary to assist in the development and updating of care plans.Participate in care team meetings to discuss active clinical issues and progress toward goals.Establish routine communication plans and communicate regularly with patients and families to assess ongoing care needs and to facilitate proactive care planning, including regular telephone contact.Serve as a liaison with insurers/payers, review resource utilization and eligibility and identify the need for and facilitate obtaining additional health insurance plete letters of medical necessity, referrals and prior authorizations as needed.Collaborate with home nursing companies and Durable Medical Equipment (DME) providers.Identify and develop relationships with community resources to support patient''s needs and makes referrals when patient care management responsibilities:Respond to referrals from inpatient teams, primary care providers or referring hospitals/facilities prior to discharge, and provide consultation on enrollment in longitudinal care management services.Establish relationships with patients who are newly enrolled in care management services prior to discharge and collaborate with the inpatient teams regarding discharge plans and anticipated outpatient care needs.Serve as a longitudinal resource for inpatient teams to obtain relevant information and updates about patients during admissions, and collaborate with inpatient teams regarding outpatient care needs and discharge plans.Facilitate scheduling post-discharge follow up telephone encounters and visits with the PCPs and specialists.Coordinate plans for follow up visits with care providers and for laboratory and diagnostic studies after discharge.Attend inpatient family meetings and care conferences when necessary to integrate inpatient care with patients'' longitudinal, intra-disciplinary care plans.Emergency Department care management responsibilities.Serve as a resource to Emergency Department providers for information about patients that will inform the Emergency Department plan of care.General registered nursing duties (including but not limited to);Obtain and document patients'' histories.Perform and document physical assessments.Conduct telephone triage and refer patients to appropriate services.Perform and/or interpret basic laboratory tests.Job Responsibilities (Continued)Professionalism and LeadershipAssist with surveys and other data collection activities to measure the effectiveness of care management interventions.Support strategies and changes as needed to improve the care management program.Serve as an institutional expert on care coordination and transition management.Enhances professional growth and development through participation in educational programs, current literature, in-service meetings and workshops.ResearchRead, analyze and synthesize nursing and other scholarly articles and research studies and share knowledge with colleagues.With assistance, apply research findings to clinical practice.Seek opportunities to participate in research studies.LearningIdentify learning needs of self and others and assists in the development of a learning plan.Apply education and training from departmental in-services and external sources to unit practices to enhance Nursing practice.Participate in the development/presentation of education programs.Demonstrate health care informatics competency in order to manage patient care, outcome data and current and emerging health care technology.Resource ManagementParticipate in promoting quality, efficient and cost-effective care.Monitor own usage of supplies and equipment/identify opportunities for improvement and makes recommendations.Manage own time to accomplish direct/indirect care in a cost-efficient manner.Other ResponsibilitiesAdheres to established departmental policies, procedures, and objectives.Maintains established department/hospital/system policies and procedures, directives, safety, environmental and infection control standards appropriate to this position.Demonstrates a courteous and professional manner through interactions with internal and external customers.Exemplifies a professional image in appearance, manner and presentation.Engages in self-performance appraisal, identifying areas of strength as well as areas for professional development.Required Licenses, Certifications, RegistrationsRegistered Nurse (Pennsylvania) - Pennsylvania State Licensing Board (upon hire)Nursing Temporary Practice Permit (Pennsylvania) - Pennsylvania State Licensing Board (upon hire)Registered Nurse (New Jersey) - New Jersey State Licensing Board (upon hire)Nursing Temporary Practice Permit (New Jersey) - New Jersey State Licensing Board (upon hire)Certification in Care Coordination and Transition Management (CCTM) - American Academy Ambulatory Care Nursing (AAACN) (within 36 months)Current Basic Life Support certification issued through an organization that requires hands-on instructor lead psychomotor skills verification (ex. American Heart Association or Red Cross)Required Education and ExperienceRequired Education: Bachelor''s Degree in NursingRequired Experience: At least five (5) years of nursing experience required.Preferred Education, Experience & Cert/LicPreferred Experience:Pediatric experienceNursing experience with a combination of outpatient and inpatient experienceAdditional Technical RequirementsComputer CompetencyNavigation and basic search functions of the Internet using Internet ExplorerUse of Outlook 2007 email, opening of attachments, attaching new files to emails and saving attached files to computerBasic use of computers, printers, monitors, patient care devices, and Fax machinesInformation LiteracyUse of Internet and Intranet to look up basic electronic resources for practiceAbility to find and print Patient Family Education DocumentsInformation Management LiteracyNavigation of electronic health information records and ability to review specific patient data in a clinical information systemUnderstanding of policies and procedures around timeliness of care, use of a clinical information system and support of safe nursing practiceAbility to discuss data presented in charts and tablesDiscuss the responsibilities of each user of an electronic record related to confidentiality and privacyCoordination of patient care information in a fragmented environment where there is partially online and partially paper referencesTo carry out its mission, it is of critical importance for the Children''s Hospital of Philadelphia (CHOP) to keep our patients, families and workforce safe and healthy and to support the health of our global community. In keeping with this, CHOP has mandated all workforce members on site at any CHOP location for any portion of their time be vaccinated for COVID-19 as a condition of employment. This mandate also applies to workforce members performing work for CHOP at non-CHOP locations. Additionally, all workforce members based in or regularly scheduled to work at any New Jersey location are mandated to be both vaccinated and boosted for COVID-19, with booster timing consistent with applicable guidelines. The CHOP COVID-19 vaccine mandate is in alignment with applicable local, state and federal mandates. CHOP also requires all workforce members who work in patient care buildings or who provide patient care to receive an annual influenza vaccine. Employees may request exemption consideration for CHOP vaccine requirements for valid religious and medical reasons. Please note start dates may be delayed until candidates are fully immunized or valid exemption requests are reviewed. In addition, candidates other than those in positions with regularly scheduled hours in New Jersey, must attest to not using tobacco products.EEO / VEVRAA Federal Contractor

Created: 2025-11-15