Case Manager

Introduction

Do you want to be appreciated daily? Our nurses are celebrated for being on the front line, empathetic for patients. At Frisbie Memorial Hospital our nurses set us apart from any other healthcare provider. We are seeking aCase Manager to join our healthcare family.

Benefits

Frisbie Memorial Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  
• Family support through fertility and family building benefits with Progyny and adoption assistance.
  
• Referral services for child, elder and pet care, home and auto repair, event planning and more
  
• Consumer discounts through Abenity and Consumer Discounts
  
• Retirement readiness, rollover assistance services and preferred banking partnerships
  
• Education assistance (tuition, student loan, certification support, dependent scholarships)
  
• Colleague recognition program
  
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

At Frisbie Memorial Hospital, our nurses play a vital part. We know that every nurse’s path and purpose is unique. Do you want to create your own personal career path in nursing? HCA Healthcare is your career destination! Our scale makes it possible for nurses to create the career path that fits their life – for life – and empowers their passion for patient care. Apply today for our Case Manager opportunity.

Job Summary and Qualifications

The Case Manager is responsible for facilitating patient progression and transition through the continuum of care. The Case Manager facilitates and coordinates the efforts of the interdisciplinary team and other entities to ensure each patient receives services at the right level of care and in the setting most appropriate to meet their needs at the right time.

Patient Population Served :

The Case Manager may work or works with the child, adolescent, adult and/or geriatric patient.

Essential Position Functions :

1. Facilitates and Coordinates Care and Services.

Communicates/collaborates with all members of the health care team, including the interdisciplinary team (e.g., physicians, nursing, SW, PT. OT, ST, nutrition, etc.), patients, physician practices, community agencies, and payors regarding patient needs, plan, and transition.

Considers patient needs to include medical, physical, psychosocial, spiritual, financial , cultural and emotional aspects.

Facilitates or participates in ad hoc patient/family conferences and with interdisciplinary team designed to gather information, identify barriers or problems, and to resolve issues around in-hospital and post-hospital care.

Educates health team colleagues about care management, including the role of the care manager. Participates in other educational programs as requested/appropriate.

Assists with explanation and obtaining Advance Directives.

May collect, analyze, enter and report care management data related to patient care and participates in continuing quality improvement.

Maintains appropriate documentation.

2. Performs Discharge Planning.

Identifies discharge planning needs through chart review, patient interview, discussion with other caregivers and/or exchange of information at multi disciplinary patient care rounds.

Considers impact of disease process and other barriers.

Develops discharge plan A and B and communicates with patients and other caregivers as appropriate.

Communicates with external case managers and other post discharge providers as appropriate.

Facilitates referral/transfer/discharge of patient to another level of care, health professional or setting.

Coordinates home IV/enteral and home health referrals, etc. Ensures that oxygen and DME ordered by other departments will be / is delivered timely to meet the patient's needs.

Refers to and collaborates with community at large to develop and implement plans for complex cases which require multi-agency involvement.

Maintains appropriate documentation.

3. Performs Utilization Review

Reviews patient medical records for appropriateness of admission and/or continued stay using established criteria. Communicates utilization issues to physician, nursing staff, social workers, business office or patient registration staff, and other appropriate persons.

Refers cases for physician review (internal or external review) as appropriate.

Coordinates and performs all follow up activities related to Medicare other third party payors, and hospital-negotiated contracts.

Assists medical staff in responding to appeals.

Provides requested information regarding patient care and services to external review and regulatory agencies.

Communicates with patients, physicians and nurses changes in review findings resulting in level of care changes and/or findings consistent with termination/denial of benefits.

Delivers HINN letters when appropriate.

Provides instruction/education to patients/families regarding appeals process upon receipt of Medicare HINN / termination of benefits letter.

Collaborates with managers and staff in the Patient Registration, Patient Accounts and HIM Departments on issues of continued stay, denials and related activities. Serves as a resource for same.

Monitors for utilization, quality of care, risk and infection control issues. Reports as needed.

Keeps Program Director, Care Coordination, Clinical and Fiscal Integration informed on matters which require notification or administrative action.

Discusses cases with attending physician. Explores and implements strategies to reduce LOS when appropriate and to optimize resource consumption.

Maintains appropriate documentation.

Ensures the security/confidentiality of patient information.

4. Assists with Patient Rights/Grievances

Responds as needed to patient grievances regarding medical necessity, appropriateness or quality of care.

Reviews with patient his/her right to file a grievance, when applicable, directly with the Medicare Quality Improvement Organization (QIO). If requested, Care Manager will assist the patient (or representatives) in complying with Medicare Grievance process.

Non-Essential Position Functions :

Participates as appropriate and is knowledgeable in fire safety, disaster, infection control and all appropriate hospital programs.

Performs other duties as needed or as judgment dictates.

Position Qualifications:

Education Required: Current and unrestricted NH RN license required.

Bachelors Degree preferred.

Experience: 3-5 years recent acute hospital experience as RN, prior discharge planning experience helpful

Certification: Case Management Certification desired

Located in the Greater Seacoast region of New Hampshire and Southern Maine, Frisbie Memorial Hospital boasts of 112 beds and is a top-notch medical facility. The hospital is owned by HCA Healthcare, which also owns two emergency rooms, an ambulatory surgery center, an urgent care center, and 46 physician practices in New Hampshire. HCA Healthcare employs 2,600 colleagues and 554 physicians in the area. The company provides $15.8 million in uncompensated care and pays $43.8 million in taxes each year. Additionally, HCA Healthcare owns Portsmouth Regional Hospital and Parkland Medical Center in Derry, as well as freestanding emergency rooms in Seabrook and Dover. In the near future, a third freestanding emergency room is set to open in Plaistow in 2023.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

Join a family that cares about every stage in your career! We are interviewing candidates for our Case Manager opening. Apply today and a member of our Talent Acquisition team will reach out.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.