Care Coordinator - ED Care Manager

Emergency Department (ED) Nurse Care Manager is responsible for establishing, coordinating, and maintaining the process to optimize patient throughput to the most appropriate level of care while facilitating interdisciplinary care across the continuum for the ED. The Nurse Care Manager collaborates with the patient/family, multidisciplinary team, physicians, community resources and payers to ensure the patient's progress and level of care is appropriately determined for the emergency episode of care and for the inpatient encounter to ensure that care is performed and facilitated in an efficient and cost-effective manner.

Include, but are not limited to:

Level of Care Determination: Completes initial medical necessity review on all ED patients with potential for admission, works with providers to identify appropriate level of care designation. Documents in accordance with established policy and procedure. Educates ED physicians and nurses about medical necessity and admission criteria.
• Refers High Risk Patients to Social Services: Utilizes Social Work screening criteria to make appropriate social work referrals. Identifies patient/families with complex psychosocial, ongoing medical discharge planning issues, continuing care needs and refers to the social worker.
• Implements Actions to Prevent Readmission: Collaborates with medical staff to recommend referrals for outpatient care, home health or other community agencies as indicated. Provides post-discharge follow-up by conducting or delegating the telephone evaluation of discharge plan. Works with time to establish interventions to manage high utilizers.
• Supports Patient Flow: Intervenes to expedite the completion of diagnostic tests needed to determine disposition, offers alternatives to admission when appropriate, engages in boarder rounds to determine any needed changes in disposition.
• Initiates discharge planning by conducting screenings for social determinants of health and initial discharge planning assessments for patients admitted through the emergency department.
• Maintains knowledge of Federal, State, and other regulatory agency rules and regulations including The Joint Commission, CMS, Medicare, including but not limited to, knowledge of CMS rules regarding Observation status, the 2 Midnight Rule, and Medicare Inpatient Only Procedures.
• Maintains knowledge of continuum of cares resources and provides education and resources relevant to the effective progression of care, utilization of services, appropriate level of care, and safe patient transition to the patient/family and health care team.
• Identifies potential risk management and/or quality issues and works with the healthcare team to resolve such issues or refer them through the Chain of Command structure to the appropriate resource/committee

Other duties as assigned by management

• BSN or Bachelor's Degree in related field or current enrollment in BSN or related Bachelor's Degree program required.
• Prior clinical experience in care and management of hospitalized patients.
• Experience in acute care utilization, preferred.
• Utilization review or case management training from a professional Case Management organization, preferred.
• RN license required/NJ.
• Case Management certification preferred.
• Excellent communication, negotiation, and conflict resolution skills
• Data and computer skills
• Knowledge of relevant and state utilization review and appeals requirements
• Rapid cycle change or clinical performance improvement expertise

CentraState Healthcare System, a partner of Atlantic Health System, is a fully accredited, not-for-profit, community-based health system that provides comprehensive health services in the central New Jersey region. In addition to offering a full range of leading-edge diagnostic and treatment options, CentraState serves as a valuable health partner focused on the latest ways to prevent disease, promote healthy behaviors, and help people of all ages live life well. Based in Freehold, CentraState is comprised of a 284-bed acute-care hospital, a vibrant health and wellness campus, two award-winning senior living communities, a charitable foundation, and convenient satellite health pavilions offering primary care and specialty physician practices, along with access to outpatient services, such as lab and physical therapy. The system also offers a family medicine residency and geriatric fellowship training program in affiliation with Rutgers Robert Wood Johnson Medical School. Among its many honors and accreditations, CentraState is one of less than two percent of hospitals nationwide to earn Magnet designation for nursing excellence four times and was designated a Great Place to Work-Certified Company by Great Place to Work for the fourth consecutive year.

When you bring your talent to CentraState, you are joining a trailblazing healthcare facility, committed to providing high-quality, patient-focused care. Join us in making incredible strides in health care, and making a difference in our community. We believe in enriching the lives of our employees through work/life balance initiatives, tuition assistance, career advancement opportunities and much more.

Find out why our employees love their jobs and being part of the CentraState family!

What We Offer:

• Highly competitive compensation
• Excellent benefits package and rewards program
• 403(b) retirement plan with company match
• 401(a) retirement plan with employer contribution
• Life Insurance
• Tuition Reimbursement Program
• Growth Opportunity and Workforce Development Initiatives
• Continuing Education / Onsite Training
• A warm, welcoming company culture based upon mutual respect and a collaborative goal of providing excellent patient care
• Concierge Services with Work & Family Benefits
• Magnet recognized healthcare facility