Catholic Charities, Diocese of Trenton
RN Care Manager/Project Evaluator
Catholic Charities, Diocese of Trenton, Trenton, New Jersey, us, 08628
Overview
RN Care Manager/Project Evaluator
– Catholic Charities, Diocese of Trenton
Job Summary Provides utilization management and systems review activities for “For My Baby & Me”. Work collaboratively with agency partners and community stakeholders and makes recommendations on protocols and systems to support optimum program/grant outcomes.
Essential Functions
Oversee evaluation activities including the development of effective data collection, monitoring and reporting in compliance with applicable grants (For My Baby and Me).
Utilizes best practice standards to render medical necessity determinations.
Analyze, evaluate and measure project outcomes and incorporate results into sustainability and strategic evaluation planning.
Write process and outcomes reports including quarterly performance assessments including protocol recommendations
Provides case consultations for complex cases and situations.
Collaborates with interdisciplinary teams to assess physical, behavioral, social and transitional care needs and assists as needed to develop person centered, integrated, recovery-oriented service plans to meet the needs of the consumer.
Monitors staff for appropriateness and congruence of application of medical necessity criteria during utilization review process. Provides training to staff as needed.
Assists in the recommendation of client/consumers care to designated collaborating agencies and monitors care and length of stay.
Recognizes quality of care issues and reports them appropriately through internal/external processes under the direction of the Nurse Executive/Director of Nursing.
Implements valid and reliable monitoring tools to conduct both quantitative and qualitative analysis of consumer care/quality measures in accordance with acceptable statistical and quality improvement processes/systems.
Manages, monitors, and reports on both concurrent and retrospective review of consumer records to ensure consumers received/are receiving the right care, in a timely and cost-effective manner and recommends solutions to improving the efficiency and effectiveness of service delivery via program administration and/or the quality improvement process.
Provide linkages, referrals, and coordination of care
Other duties as assigned by nurse executive/director of nursing
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Individual and Family Services
#J-18808-Ljbffr
– Catholic Charities, Diocese of Trenton
Job Summary Provides utilization management and systems review activities for “For My Baby & Me”. Work collaboratively with agency partners and community stakeholders and makes recommendations on protocols and systems to support optimum program/grant outcomes.
Essential Functions
Oversee evaluation activities including the development of effective data collection, monitoring and reporting in compliance with applicable grants (For My Baby and Me).
Utilizes best practice standards to render medical necessity determinations.
Analyze, evaluate and measure project outcomes and incorporate results into sustainability and strategic evaluation planning.
Write process and outcomes reports including quarterly performance assessments including protocol recommendations
Provides case consultations for complex cases and situations.
Collaborates with interdisciplinary teams to assess physical, behavioral, social and transitional care needs and assists as needed to develop person centered, integrated, recovery-oriented service plans to meet the needs of the consumer.
Monitors staff for appropriateness and congruence of application of medical necessity criteria during utilization review process. Provides training to staff as needed.
Assists in the recommendation of client/consumers care to designated collaborating agencies and monitors care and length of stay.
Recognizes quality of care issues and reports them appropriately through internal/external processes under the direction of the Nurse Executive/Director of Nursing.
Implements valid and reliable monitoring tools to conduct both quantitative and qualitative analysis of consumer care/quality measures in accordance with acceptable statistical and quality improvement processes/systems.
Manages, monitors, and reports on both concurrent and retrospective review of consumer records to ensure consumers received/are receiving the right care, in a timely and cost-effective manner and recommends solutions to improving the efficiency and effectiveness of service delivery via program administration and/or the quality improvement process.
Provide linkages, referrals, and coordination of care
Other duties as assigned by nurse executive/director of nursing
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Individual and Family Services
#J-18808-Ljbffr