What are the responsibilities and job description for the RN Case Manager - Northeast Peds position at St. Christopher's Hospital for Children?
Job Summary
The Case Manager coordinates, manages and procures the discharge needs of patients identified as requiring post acute care services via initial admission screen, assessment and consults. This is achieved by collaboration with the family, the care team including physicians, nursing and other healthcare professionals. The Case Manager performs daily utilization review and conveys pertinent telephonic information to third party payers to secure appropriate acute care reimbursement within the time requirements of the payer. The Case Manager appeals 100% of all third party payer denials for acute care reimbursement according to the guidelines for satellite St. Christopher's Pediatric Associates locations. The Case Manager performs ongoing PI/QA during concurrent review to identify quality of care issues, risk management issues, and performs blood/blood products and medication utilization.
Schedule: . Mon 9am-6pm , Tues 9am-330pm, Wed 9am-6pm, Thurs 9am-330pm, Friday 8am-5pm. The scheduled start and end times require flexibility to meet the needs of the practice.
#STC
Qualifications
Education Requirements
About St. Christopher's Hospital for Children
St. Christopher’s Hospital for Children, a partnership between Tower Health and Drexel University, is a 188-bed facility that provides exceptional care to children throughout the Greater Philadelphia area and surrounding counties.
St. Christopher's has more than 220 pediatric experts on staff, combining top-notch pediatric care with a wide array of pediatric specialties including Cardiology, Ear, Nose and Throat, Gastroenterology, Oncology, and Orthopedics. It houses the only Verified Pediatric Burn Center between New York City and Baltimore and is one of only three Level I Pediatric Trauma Centers in Pennsylvania. St. Christopher’s is a Magnet® designated hospital and was recognized as a Women’s Choice Award Best Children’s Hospital.
In addition to its main location in Philadelphia, the hospital has a growing network of primary and specialty care locations throughout the Philadelphia suburbs and New Jersey so your child's health conditions can be treated close to home.
About The Organization
Tower Health, a regional healthcare system, serves communities across multiple counties in Pennsylvania. Its network includes Reading Hospital, Phoenixville Hospital, Pottstown Hospital, and St. Christopher's Hospital for Children (in partnership with Drexel University). Committed to academic medicine and training, Tower Health offers various programs, including residency and fellowship programs, the Drexel University College of Medicine at Tower Health, and the Reading Hospital School of Health Sciences. Additionally, the system provides a wide range of healthcare services, such as Reading Hospital Rehabilitation at Wyomissing, home healthcare via Tower Health at Home, TowerDirect ambulance and emergency response, Tower Health Medical Group, Tower Health Providers (a clinically integrated network), and Tower Health Urgent Care facilities across its service area.
Discover why our hospital is a great place to work—take a virtual tour of our facility here: St. Chris Virtual Tour
The Case Manager coordinates, manages and procures the discharge needs of patients identified as requiring post acute care services via initial admission screen, assessment and consults. This is achieved by collaboration with the family, the care team including physicians, nursing and other healthcare professionals. The Case Manager performs daily utilization review and conveys pertinent telephonic information to third party payers to secure appropriate acute care reimbursement within the time requirements of the payer. The Case Manager appeals 100% of all third party payer denials for acute care reimbursement according to the guidelines for satellite St. Christopher's Pediatric Associates locations. The Case Manager performs ongoing PI/QA during concurrent review to identify quality of care issues, risk management issues, and performs blood/blood products and medication utilization.
Schedule: . Mon 9am-6pm , Tues 9am-330pm, Wed 9am-6pm, Thurs 9am-330pm, Friday 8am-5pm. The scheduled start and end times require flexibility to meet the needs of the practice.
#STC
Qualifications
Education Requirements
- 4 year/Bachelor's Degree
- Completes and maintains all competencies and trainings as required for role.
- Relevant Experience
- PA Registered Nurse License
- Computer Skills to include use and navigation
- Excellent Communications Skills
- Excellent Interpersonal Skills
- Microsoft Office Applications
About St. Christopher's Hospital for Children
St. Christopher’s Hospital for Children, a partnership between Tower Health and Drexel University, is a 188-bed facility that provides exceptional care to children throughout the Greater Philadelphia area and surrounding counties.
St. Christopher's has more than 220 pediatric experts on staff, combining top-notch pediatric care with a wide array of pediatric specialties including Cardiology, Ear, Nose and Throat, Gastroenterology, Oncology, and Orthopedics. It houses the only Verified Pediatric Burn Center between New York City and Baltimore and is one of only three Level I Pediatric Trauma Centers in Pennsylvania. St. Christopher’s is a Magnet® designated hospital and was recognized as a Women’s Choice Award Best Children’s Hospital.
In addition to its main location in Philadelphia, the hospital has a growing network of primary and specialty care locations throughout the Philadelphia suburbs and New Jersey so your child's health conditions can be treated close to home.
About The Organization
Tower Health, a regional healthcare system, serves communities across multiple counties in Pennsylvania. Its network includes Reading Hospital, Phoenixville Hospital, Pottstown Hospital, and St. Christopher's Hospital for Children (in partnership with Drexel University). Committed to academic medicine and training, Tower Health offers various programs, including residency and fellowship programs, the Drexel University College of Medicine at Tower Health, and the Reading Hospital School of Health Sciences. Additionally, the system provides a wide range of healthcare services, such as Reading Hospital Rehabilitation at Wyomissing, home healthcare via Tower Health at Home, TowerDirect ambulance and emergency response, Tower Health Medical Group, Tower Health Providers (a clinically integrated network), and Tower Health Urgent Care facilities across its service area.
Discover why our hospital is a great place to work—take a virtual tour of our facility here: St. Chris Virtual Tour
