As one of the nation's leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children â“ even those who may never enter our doors â“ through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own.
Summary: The Case Management Nurse is a registered nurse who coordinates all aspects of the care of individual patients. Through the use of the nursing process, the patient care will be assessed, planned, implemented and evaluated with consideration to the appropriate use of resources. The Case Manager will manage care with a focus on designated clinical, operational and financial outcomes for aggregate patient populations. In collaboration with the interdisciplinary team and a family-centered process, the Case Management nurse will work to improve outcomes as measured by coordinating care to the correctly timed discharge, reduced readmission rates and improved patient/family satisfaction. Using the Standards for Case Management as a framework, will incorporate ethical and legal tenets into the essential job functions.
The Case Manager in the PICU will have a caseload of approximately 24 patients and will work closely with the care team to ensure care, family education and discharge are done timely with a plan to safely and successfully transition patients to home at discharge.
Conduct a comprehensive assessment of the patient's health and psychosocial needs, including health literacy status and deficits, and develop a case management plan in collaboration with the family.
Facilitate communication and coordination between members of the health care team, involving the family in the decision-making process in order to minimize fragmentation.
Ensure correct level of utilization of services and resources for a select group of patients.
Chart reviews are completed daily.
Based on nationally recognized criteria, medical necessity for admission and continued stay is evaluated and presented to the team.
Communicate with the payor liaison to ensure proper utilization of patient care resources in the hospital and in the community at the time of discharge.
The Case Manager oversees the delivery of care from admission through discharge and transition to the home environment.
Family-centered assessment and discharge planning is started within 24 hours of admission.
Documentation is done clearly and concisely in the patient chart.
A plan of care with a path to home is developed with the interdisciplinary care team.
Through a family-centered, interdisciplinary approach, the team can anticipate potential barriers and work together to ensure they are managed before delaying care, transition or discharge.
Family education for care in the home is initiated by the direct care nurses and is kept on track. The Case Manager collaborates with the direct care nurses to evaluate progression of education and to surface any barriers to learning care.
Anticipates discharge needs in terms of equipment, resources and follow-up care so that arrangements can be initiated as early in the course as possible.
Case Managers work closely with Social Workers to ensure a safe and successful discharge.
The Case Manager is able to reprioritize based on changing needs of the patient aggregate and plan accordingly.
Education and Training
Pediatric experience required, minimum of 5 years.
Delaware Nursing licensure required.
Certification in Case Management preferred; attainment within 2 years of employment.
Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique âœBridge to a Healthy Futureâ pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.